MEDICARE: CHRIS R. SWARTWOOD PT

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	225100000X	Physical Therapist	26556	CA

General Provider Information

NPI Number	:	1346409257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS R. SWARTWOOD PT

Provider Business Mailing Address
First Line	:	805 AEROVISTA PL
Second Line	:	201
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-7919
Country	:	US
Telephone Number	:	805-788-0805
Fax Number	:	805-788-0845

Provider Business Practice Location Address
First Line	:	2401 W TURNER RD
Second Line	:	250
City	:	LODI
State	:	CA
Zip	:	95242-2182
Country	:	US
Telephone Number	:	805-334-2224
Fax Number	:	805-334-2225

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	05/24/2010

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