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General NPI Number Information
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NPI Number | 1861678955
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Entity Type | Organization
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Legal Business Name | JEFFREY C.SWINK CHIROPRACITIC INC.
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 31508 RAILROAD CANYON RD
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City | CANYON LAKE
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State | CA
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Zip | 92587-9413
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Country | US
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Telephone | 951-764-9054
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Fax |
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Provider Business Mailing Address
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Address Line | 30191 WHITE WAKE DR
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City | CANYON LAKE
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State | CA
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Zip | 92587-7493
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Country | US
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Telephone | 951-764-9054
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY SWINK
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Credential | D.C.
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Telephone | 951-764-9054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC24003
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License Number State | CA
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