Healthcare Provider Details

I. General information

NPI: 1043655152
Provider Name (Legal Business Name): CATHERINE ELEANOR SWIFT-VERLY L. AC., AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 E VENICE AVE
VENICE FL
34292-3191
US

IV. Provider business mailing address

1600 KENILWORTH ST
SARASOTA FL
34231-3525
US

V. Phone/Fax

Practice location:
  • Phone: 941-486-8126
  • Fax:
Mailing address:
  • Phone: 941-724-1261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3068
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: