Provider Demographics
NPI:1588291835
Name:SWANSON, GEOFFREY KURT (PT)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:KURT
Last Name:SWANSON
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 1:2590 NORTHAM CIR NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-5715
Mailing Address - Country:US
Mailing Address - Phone:330-280-7384
Mailing Address - Fax:
Practice Address - Street 1:585 WHITE POND DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1115
Practice Address - Country:US
Practice Address - Phone:330-869-6014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT005633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist