Organization
EVERGREEN PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE VAN DRIL SWAIN PT (PHYSICAL THERAPIST)
(269) 381-0737
Entity
Organization
Contact information
Practice address
611 HOWARD ST, KALAMAZOO, MI 49008-1919
(269) 381-0737
(269) 381-5120
Mailing address
611 HOWARD ST, KALAMAZOO, MI 49008-1919
(269) 381-0737
(269) 381-5120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005239
MI
Other
Enumeration date
06/26/2007
Last updated
09/18/2007
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