Provider Demographics
NPI:1104857317
Name:SWINK, ROBERT RAY (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RAY
Last Name:SWINK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 N FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2304
Mailing Address - Country:US
Mailing Address - Phone:805-967-1254
Mailing Address - Fax:805-683-3512
Practice Address - Street 1:139 N FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2304
Practice Address - Country:US
Practice Address - Phone:805-967-1254
Practice Address - Fax:805-683-3512
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADC10966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC10966Medicare ID - Type UnspecifiedCHIROPRACTIC