Swanke, Tina Lorene

Swanke, Tina Lorene is an sole proprietor health care provider with primary practice located at 147 N State St , Berlin WI 54923-1621. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Swanke, Tina Lorene can be contacted via phone (920) 361-3515.

Contact Information

Primary practice address
147 N State St Berlin WI 54923-1621
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 729-026 Wisconsin

Profile Details

NPI number 1063511061
LBN Legal business name Swanke, Tina Lorene
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063511061 NPPES
Wisconsin MEDICAID 40729700

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