Organization Name: | SW PHYSICAL THERAPY |
NPI Number: | 1235310814 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL FRANZ STIWICH (SECRETARY) |
Mailing Address: | 5715 Cantor Ave North Port |
State: | FL US |
Postal Code: | 342915620 |
Phone Number: | 9412406251 |
Fax Number: | 9412406251 |
NPI Enumeration Date: | 11/23/2007 |
NPI Last Update Date: | 11/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |