Provider Demographics
NPI:1942293212
Name:SWARTZ, GREGORY WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:WAYNE
Last Name:SWARTZ
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 1:814 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4041
Mailing Address - Country:US
Mailing Address - Phone:307-682-3013
Mailing Address - Fax:307-686-2350
Practice Address - Street 1:814 E 6TH ST
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4041
Practice Address - Country:US
Practice Address - Phone:307-682-3013
Practice Address - Fax:307-686-2350
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor