Provider Demographics
NPI:1619532199
Name:SWMI HEALTH MATTERS PLLC
Entity Type:Organization
Organization Name:SWMI HEALTH MATTERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:OPDYCKE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:269-220-0648
Mailing Address - Street 1:5708 VENTURE CT STE A
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2858
Mailing Address - Country:US
Mailing Address - Phone:269-220-0648
Mailing Address - Fax:269-220-3535
Practice Address - Street 1:5708 VENTURE CT STE A
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2858
Practice Address - Country:US
Practice Address - Phone:269-220-0648
Practice Address - Fax:269-220-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty