Provider Demographics
NPI:1417094913
Name:SWART, GARY H (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:H
Last Name:SWART
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 1:404 FINCHER RD
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3533
Mailing Address - Country:US
Mailing Address - Phone:318-371-0558
Mailing Address - Fax:318-377-9008
Practice Address - Street 1:404 FINCHER RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3533
Practice Address - Country:US
Practice Address - Phone:318-371-0558
Practice Address - Fax:318-377-9008
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S801Medicare ID - Type UnspecifiedCHIROPRACTOR