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General NPI Number Information
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NPI Number | 1548808496
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Entity Type | Individual
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Provider Name | MICHAEL SWIENTON PT, DPT, CSCS
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Gender | Male
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 270 INTERNATIONAL CIR
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City | SAN JOSE
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State | CA
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Zip | 95119-1100
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Country | US
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Telephone | 408-972-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 CHARLEVOIX DR SE STE 200
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7086
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Country | US
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Telephone | 800-634-1077
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 045101
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License Number State | NY
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