MEDICARE: DR. JEFF C. SWINK D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC24003	CA

General Provider Information

NPI Number	:	1093839698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF C. SWINK D.C.

Provider Business Mailing Address
First Line	:	31532 RAILROAD CANYON RD
Second Line	:	SUITE 112
City	:	CANYON LAKE
State	:	CA
Zip	:	92587-9437
Country	:	US
Telephone Number	:	951-244-4040
Fax Number	:	951-244-6622

Provider Business Practice Location Address
First Line	:	31532 RAILROAD CANYON RD
Second Line	:	SUITE 112
City	:	CANYON LAKE
State	:	CA
Zip	:	92587-9437
Country	:	US
Telephone Number	:	951-244-4040
Fax Number	:	951-244-6622

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/02/2008

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