Provider Demographics
NPI:1801151402
Name:ERIC J SWEDA DC PA
Entity type:Organization
Organization Name:ERIC J SWEDA DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWEDA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-326-8811
Mailing Address - Street 1:1326 W NORTH BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-3997
Mailing Address - Country:US
Mailing Address - Phone:352-326-8811
Mailing Address - Fax:352-787-9586
Practice Address - Street 1:1326 W NORTH BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3997
Practice Address - Country:US
Practice Address - Phone:352-326-8811
Practice Address - Fax:352-787-9586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty