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NPI 1467476994

NPI 1467476994 : KRISTIN MARIE SWARTZ ATC : PERRYSBURG, OH

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General NPI Number Information
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    NPI Number           |    1467476994
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTIN MARIE SWARTZ ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/27/2006
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    Last Update Date     |    07/13/2011
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Provider Practice Location Address
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    Address Line         |    28555 STARBRIGHT BLVD SUITE B
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    City                 |    PERRYSBURG
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    State                |    OH
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    Zip                  |    43551-5662
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    Country              |    US
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    Telephone            |    419-931-3030
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    Fax                  |    419-931-3046
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Provider Business Mailing Address
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    Address Line         |    26932 PEMBERVILLE RD 
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    City                 |    PERRYSBURG
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    State                |    OH
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    Zip                  |    43551-9742
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    Country              |    US
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    Telephone            |    419-837-9139
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    000545
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    License Number State |    OH
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