Healthcare Provider Details

I. General information

NPI: 1275693939
Provider Name (Legal Business Name): JODI MARIE SWARTZ D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 E CLAIREMONT AVE
EAU CLAIRE WI
54701-4768
US

IV. Provider business mailing address

1503 LARSON ST
BLOOMER WI
54724-1632
US

V. Phone/Fax

Practice location:
  • Phone: 715-835-9514
  • Fax:
Mailing address:
  • Phone: 715-568-4220
  • Fax: 715-568-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4191012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: