Provider Demographics
NPI:1447295670
Name:SWIGER, WANDA S (ED, D, ATC)
Entity type:Individual
Prefix:PROF
First Name:WANDA
Middle Name:S
Last Name:SWIGER
Suffix:
Gender:F
Credentials:ED, D, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E FAIRVIEW AVE
Mailing Address - Street 2:BOX 126, 121 C CLOVERDALE
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-2114
Mailing Address - Country:US
Mailing Address - Phone:334-833-4455
Mailing Address - Fax:
Practice Address - Street 1:1500 E FAIRVIEW AVE
Practice Address - Street 2:BOX 126, 121 C CLOVERDALE
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2114
Practice Address - Country:US
Practice Address - Phone:334-833-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer