Provider Demographics
NPI:1003523143
Name:SWISHER, NOAH J
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:J
Last Name:SWISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 N FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-2551
Mailing Address - Country:US
Mailing Address - Phone:571-425-0559
Mailing Address - Fax:
Practice Address - Street 1:550 BRANDON AVE.
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22904-2290
Practice Address - Country:US
Practice Address - Phone:571-425-0559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer