Provider Demographics
NPI:1073351102
Name:SWAIN-PERDUE, SONYA SHANETTE
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:SHANETTE
Last Name:SWAIN-PERDUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 COLBURN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-3245
Mailing Address - Country:US
Mailing Address - Phone:419-324-9509
Mailing Address - Fax:
Practice Address - Street 1:863 COLBURN ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-3245
Practice Address - Country:US
Practice Address - Phone:419-324-9509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)