Provider Demographics
NPI:1396370839
Name:SWIFT, AARON PAUL (MSOTRL)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:PAUL
Last Name:SWIFT
Suffix:
Gender:M
Credentials:MSOTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 OKEEFE RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1312
Mailing Address - Country:US
Mailing Address - Phone:269-986-2631
Mailing Address - Fax:
Practice Address - Street 1:1404 OKEEFE RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1312
Practice Address - Country:US
Practice Address - Phone:269-986-2631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007951225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty