Individual
KEVIN ALAN SWINDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPTA
Contact information
Practice address
104 W MARKET ST, SUITE B, OSAGE CITY, KS 66523-1277
(785) 528-1123
(785) 528-4123
Mailing address
104 W MARKET ST, SUITE B, OSAGE CITY, KS 66523-1277
(785) 528-1123
(785) 528-4123
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1400751
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235242460
GROUP NPI
KS
01
—
20-5322594
COMPANY TAX ID#
KS
01
—
200431220A
KMAP GROUP NUMBER
KS
Enumeration date
09/20/2010
Last updated
09/20/2010
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