Provider Demographics
NPI:1871532812
Name:SWAVELY, THOMAS A (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:SWAVELY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:8125 ADAMS DR
Practice Address - Street 2:SUITE B
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-8625
Practice Address - Country:US
Practice Address - Phone:717-220-2020
Practice Address - Fax:717-220-2010
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005360L225100000X
MD21717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50041074OtherCAPITAL BC
PA198644OtherPA BLUE SHIELD
PA198644R9XMedicare Oscar/Certification