Basic Information
| Provider Information | |||||||||
| NPI: | 1588871446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWART | ||||||||
| FirstName: | PAUL | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2615 CENTENNIAL BLVD STE 101 | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323080589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8506561837 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2615 CENTENNIAL BLVD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323080586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8506561837 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 10/06/2015 | ||||||||
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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 | 2251X0800X | PT25224 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 2251X0800X | PT25224 | IN | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.