MEDICARE: MS. KATHRYN DEENA SWORE D.P.T

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1427501725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHRYN DEENA SWORE D.P.T

Provider Business Mailing Address
First Line	:	3190 E MERIDIAN PARK LOOP STE 206A
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99654-7422
Country	:	US
Telephone Number	:	907-373-9462
Fax Number	:	907-373-9464

Provider Business Practice Location Address
First Line	:	3190 E MERIDIAN PARK LOOP STE 206A
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99654-7422
Country	:	US
Telephone Number	:	907-373-9462
Fax Number	:	907-373-9464

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2016
Last Update Date	:	07/29/2025

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