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NPI Code Detail

MEDICARE: MRS. JOANNA AMELIA SWIONTEK CTRS

MEDICARE: MRS. JOANNA AMELIA SWIONTEK CTRS
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
1225800000XRecreation TherapistS532421066886MI

General Provider Information

NPI Number : 1467772061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOANNA AMELIA SWIONTEK CTRS
Provider Business Mailing Address
First Line : 4634 OAKLAWN DR
Second Line :
City : PINCKNEY
State : MI
Zip : 48169-8704
Country : US
Telephone Number : 517-795-6021
Fax Number :
Provider Business Practice Location Address
First Line : 35514 INDIGO DR
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4946
Country : US
Telephone Number : 586-979-8118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2010
Last Update Date : 06/04/2010

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