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NPI Code Detail

MEDICARE: MR. RYAN KN SWENSON MSPT

MEDICARE:  MR. RYAN KN SWENSON  MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1311SD

General Provider Information

NPI Number : 1104990738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN KN SWENSON MSPT
Provider Business Mailing Address
First Line : 816 PINE ST
Second Line :
City : BRANDON
State : SD
Zip : 57005-1086
Country : US
Telephone Number : 605-582-8718
Fax Number :
Provider Business Practice Location Address
First Line : 1721 S CLEVELAND AVE
Second Line : 200
City : SIOUX FALLS
State : SD
Zip : 57103-5501
Country : US
Telephone Number : 605-334-8616
Fax Number : 605-339-6982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/08/2007

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Directions to “ MR. RYAN KN SWENSON MSPT” Practice Location

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