Provider Demographics
NPI:1265014104
Name:SWART, JULIE L (RDCS, RVT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:L
Last Name:SWART
Suffix:
Gender:F
Credentials:RDCS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 MALVERN LAKES CIR APT 301
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-7251
Mailing Address - Country:US
Mailing Address - Phone:219-902-2787
Mailing Address - Fax:
Practice Address - Street 1:451 MALVERN LAKES CIR APT 301
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22406-7251
Practice Address - Country:US
Practice Address - Phone:219-902-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1309602085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound