Healthcare Provider Details

I. General information

NPI: 1780302638
Provider Name (Legal Business Name): DR. KAYLA SWINGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 E MARKET ST
CHARLOTTESVILLE VA
22902-5374
US

IV. Provider business mailing address

1616 OHIO ST
WAYNESBORO VA
22980-2331
US

V. Phone/Fax

Practice location:
  • Phone: 434-293-6165
  • Fax:
Mailing address:
  • Phone: 540-249-5154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104557801
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: