Healthcare Provider Details
I. General information
NPI: 1598056418
Provider Name (Legal Business Name): AMY MICHELLE SWERTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2011
Last Update Date: 07/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1701 N GREEN VALLEY PKWY BUILDING 8 STE B
HENDERSON NV
89074-5885
US
IV. Provider business mailing address
2433 VILLAGE GLEN CT
MARYLAND HEIGHTS MO
63043-1529
US
V. Phone/Fax
- Phone: 702-998-3333
- Fax:
- Phone: 314-878-4544
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 2528 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: