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General NPI Number Information
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NPI Number | 1821382136
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Entity Type | Individual
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Provider Name | LISA JAN SWARTZENDRUBER P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 1350 KIRTS BLVD SUITE 120
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City | TROY
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State | MI
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Zip | 48084-4851
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Country | US
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Telephone | 248-244-7927
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Fax |
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Provider Business Mailing Address
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Address Line | 3448 PRIMROSE DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5239
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Country | US
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Telephone | 248-844-9168
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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 | 5501003632
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License Number State | MI
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