Individual
INNA SWANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
7 WILLOW BEND DR, HATTIESBURG, MS 39402-8552
(501) 908-5216
Mailing address
7 WILLOW BEND DR, HATTIESBURG, MS 39402-8552
(501) 908-5216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4451
MS
225100000X
Physical Therapist
PT2564
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145581721
—
AR
01
—
5X297
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/22/2006
Last updated
01/07/2009
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