Healthcare Provider Details

I. General information

NPI: 1750356945
Provider Name (Legal Business Name): SWANSON ORTHOTICS & PROSTHETICS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 S SHOOP AVE SUITE 3
WAUSEON OH
43567-1735
US

IV. Provider business mailing address

735 S SHOOP AVE SUITE 3
WAUSEON OH
43567-1735
US

V. Phone/Fax

Practice location:
  • Phone: 419-335-6400
  • Fax: 419-335-6700
Mailing address:
  • Phone: 419-335-6400
  • Fax: 419-335-6700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS J FITZPATRICK
Title or Position: VICE PRESIDENT
Credential:
Phone: 610-644-7824