Provider Demographics
NPI:1528402674
Name:SWIFT, CARLY (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:
Last Name:SWIFT
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 1:3809 JEFFERSON BLVD
Mailing Address - Street 2:SAME
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1605
Mailing Address - Country:US
Mailing Address - Phone:757-358-0700
Mailing Address - Fax:
Practice Address - Street 1:4640 SHORE DR STE 106
Practice Address - Street 2:SAME
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2859
Practice Address - Country:US
Practice Address - Phone:757-358-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557053111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor