Basic Information
| Provider Information | |||||||||
| NPI: | 1497027734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWIRSDING | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | MOTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9850 OLD PERRY HWY | ||||||||
| Address2: | |||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150909311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123667900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9850 OLD PERRY HWY | ||||||||
| Address2: | |||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150909311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123667900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2012 | ||||||||
| LastUpdateDate: | 02/02/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC007712L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.