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NPI Code Detail

MEDICARE: THOMAS SWANK

MEDICARE: THOMAS SWANK
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1578391280
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS SWANK
Provider Business Mailing Address
First Line : 636 BROOK ST
Second Line :
City : LANSING
State : MI
Zip : 48906-5007
Country : US
Telephone Number : 517-763-9993
Fax Number :
Provider Business Practice Location Address
First Line : 316 MOORES RIVER DR
Second Line :
City : LANSING
State : MI
Zip : 48910-1434
Country : US
Telephone Number : 517-887-0226
Fax Number : 517-887-8121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2024
Last Update Date : 07/24/2024

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Directions to “ THOMAS SWANK ” Practice Location

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