Healthcare Provider Details

I. General information

NPI: 1023652757
Provider Name (Legal Business Name): MARIE T SWARTZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11974 EDGEHILL TERRACE RD
PRINCESS ANNE MD
21853-2105
US

IV. Provider business mailing address

500 RIVERSIDE DR UNIT 120
POCOMOKE CITY MD
21851-1064
US

V. Phone/Fax

Practice location:
  • Phone: 410-651-0011
  • Fax: 410-621-8023
Mailing address:
  • Phone: 410-274-9821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number18432
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: