Healthcare Provider Details

I. General information

NPI: 1053562769
Provider Name (Legal Business Name): DENISE ELAINE SCHWIND PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CHERRY ST
PHILADELPHIA PA
19106-1803
US

IV. Provider business mailing address

PO BOX 418 419 THOMAS ST.
ALBURTIS PA
18011-0418
US

V. Phone/Fax

Practice location:
  • Phone: 800-974-6383
  • Fax: 800-974-4241
Mailing address:
  • Phone: 610-966-8553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE007210
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: