Provider Demographics
NPI:1275693939
Name:SWARTZ, JODI MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:MARIE
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 LARSON ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMER
Mailing Address - State:WI
Mailing Address - Zip Code:54724-1632
Mailing Address - Country:US
Mailing Address - Phone:715-568-4220
Mailing Address - Fax:715-568-4201
Practice Address - Street 1:2105 E CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4768
Practice Address - Country:US
Practice Address - Phone:715-835-9514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4191012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38966600Medicaid
WI38966600Medicaid