Provider Demographics
NPI:1619706579
Name:SWIM, CONNOR (DPT)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:
Last Name:SWIM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:434-381-6090
Mailing Address - Fax:434-509-1695
Practice Address - Street 1:115 AMBRIAR PLZ
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:VA
Practice Address - Zip Code:24521-4741
Practice Address - Country:US
Practice Address - Phone:434-381-6090
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA126888225100000X
MOCP033140T225100000X
VACP048641T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist