Individual
DENISE DIANE SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7712 SNIDER RD, GILMER, TX 75645-3915
(903) 734-1194
Mailing address
7712 SNIDER RD, GILMER, TX 75645-3915
(903) 452-8508
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
2012175
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012175
PTA LICENSE
TX
Enumeration date
08/22/2018
Last updated
08/22/2018
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