Clifford Daniel Thomas Swann
Physical Therapy Assistant in Lagrange, GA. Individual provider (NPI-1).
NPI number1932800935
StatusActive
Last updated in NPPESMar 15, 2023
Details
- NPI
- 1932800935
- Entity type
- Individual (NPI-1)
- Name
- Clifford Daniel Thomas Swann
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 15, 2023
- Certification date
- Mar 15, 2023
- Last updated
- Mar 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | PTA004873 | GA | Yes |
| 225200000X | Physical Therapy Assistant | PTA10782 | AL |
Practice location
1805 Vernon RdLagrange, GA 30240-3871
Phone 706-710-9723
Mailing address
1063 Priddy RdLagrange, GA 30241-9604
Phone 706-885-2881
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