Provider Demographics
NPI:1730494873
Name:SWIASTYN, ALLISON MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MARIE
Last Name:SWIASTYN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 US 31 S
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-2223
Mailing Address - Country:US
Mailing Address - Phone:231-723-8500
Mailing Address - Fax:
Practice Address - Street 1:1560 US 31 S
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-2223
Practice Address - Country:US
Practice Address - Phone:231-723-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist