Healthcare Provider Details

I. General information

NPI: 1851285126
Provider Name (Legal Business Name): SWB COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 COLONIAL PARK DR STE 306
ROSWELL GA
30075-3770
US

IV. Provider business mailing address

570 COLONIAL PARK DR STE 306
ROSWELL GA
30075-3770
US

V. Phone/Fax

Practice location:
  • Phone: 423-838-9330
  • Fax:
Mailing address:
  • Phone: 423-838-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRYAN BIERLY
Title or Position: MANAGING PARTNER
Credential:
Phone: 423-838-9330