Provider Demographics
NPI:1366574345
Name:SWENDROWSKI, CARRIE L (PT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:SWENDROWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W4026 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:EAST TROY
Mailing Address - State:WI
Mailing Address - Zip Code:53120-1609
Mailing Address - Country:US
Mailing Address - Phone:262-366-9200
Mailing Address - Fax:
Practice Address - Street 1:1020 JAMES DR STE E
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8305
Practice Address - Country:US
Practice Address - Phone:262-928-7444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6324-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist