Provider Demographics
NPI:1366738973
Name:SWAGGER, SARAH ELIZABETH (PTA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:SWAGGER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 184
Mailing Address - Street 2:360 CONCORD DRIVE
Mailing Address - City:WHITE PLAINS
Mailing Address - State:KY
Mailing Address - Zip Code:42464
Mailing Address - Country:US
Mailing Address - Phone:270-676-8251
Mailing Address - Fax:
Practice Address - Street 1:206 S WARREN ST
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:KY
Practice Address - Zip Code:42261-9418
Practice Address - Country:US
Practice Address - Phone:270-875-6246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA02544225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant