Provider Demographics
NPI:1619548328
Name:SWYERS, HOLLY (LAC)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:SWYERS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-6718
Mailing Address - Country:US
Mailing Address - Phone:323-327-8989
Mailing Address - Fax:
Practice Address - Street 1:850 COLORADO BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1762
Practice Address - Country:US
Practice Address - Phone:323-327-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-03
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17737171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist