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General NPI Number Information
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NPI Number | 1366738973
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH SWAGGER PTA
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 206 S WARREN ST
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City | MORGANTOWN
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State | KY
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Zip | 42261-9418
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Country | US
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Telephone | 270-875-6246
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 184 360 CONCORD DRIVE
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City | WHITE PLAINS
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State | KY
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Zip | 42464
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Country | US
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Telephone | 270-676-8251
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A02544
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License Number State | KY
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