Provider Demographics
NPI:1346409257
Name:SWARTWOOD, CHRIS R (PT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:R
Last Name:SWARTWOOD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:805 AEROVISTA PL
Mailing Address - Street 2:201
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7919
Mailing Address - Country:US
Mailing Address - Phone:805-788-0805
Mailing Address - Fax:805-788-0845
Practice Address - Street 1:2401 W TURNER RD
Practice Address - Street 2:250
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-2182
Practice Address - Country:US
Practice Address - Phone:805-334-2224
Practice Address - Fax:805-334-2225
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA26556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAN537WMedicare PIN