Doctor Name: | MISS MALLORY JO SWENSON |
NPI Number: | 1639348972 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 004176 |
Business Practice Address: | 1410 Sw Tradition Dr Ste 290 Ankeny, IA - 500239188 |
Business Phone Number: | 5158759706 |
Business Fax Number: | 5158759707 |
Mailing Address: | 6800 Lake Dr, Ste 250 WEST DES MOINES |
State: | IA |
Postal Code: | 502662500 |
Phone Number: | 5158759925 |
Fax Number: | 5158759923 |
NPI Enumeration Date: | 02/20/2008 |
NPI Last Update Date: | 09/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 004176 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |