Provider Demographics
NPI:1265651145
Name:SWEDROCK, KATHERYN J (ND)
Entity Type:Individual
Prefix:DR
First Name:KATHERYN
Middle Name:J
Last Name:SWEDROCK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 W LINDA LN
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6778
Mailing Address - Country:US
Mailing Address - Phone:480-220-0913
Mailing Address - Fax:
Practice Address - Street 1:633 E RAY RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4200
Practice Address - Country:US
Practice Address - Phone:480-510-1747
Practice Address - Fax:480-664-2093
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06-950175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath