Healthcare Provider Details
I. General information
NPI: 1598404733
Provider Name (Legal Business Name): MARIA N SWINEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/03/2022
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15051 HARMONY HILLS LN
ABINGDON VA
24211-7661
US
IV. Provider business mailing address
11298 LOGAN CREEK RD
MEADOWVIEW VA
24361-4034
US
V. Phone/Fax
- Phone: 276-451-2590
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: