Individual
MS. ANITA LOUISE SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 FAYETTE AVE, FAYETTEVILLE, WV 25840
(304) 574-1176
(304) 574-3643
Mailing address
111 PARK DRIVE, FAYETTEVILLE, WV 25840
(304) 640-1019
(304) 574-3643
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2578
MN
225100000X
Physical Therapist
Primary
731
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156354000
—
WV
Enumeration date
05/04/2007
Last updated
07/08/2007
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