MEDICARE: DR. TIMOTHY A SWIHART DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	08001362A	IN

General Provider Information

NPI Number	:	1497723340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY A SWIHART DC

Provider Business Mailing Address
First Line	:	418 E DUPONT RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-2050
Country	:	US
Telephone Number	:	260-489-6019
Fax Number	:	260-489-6136

Provider Business Practice Location Address
First Line	:	1724 PRAIRIE LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46818-1057
Country	:	US
Telephone Number	:	260-489-7949
Fax Number	:	260-489-8721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	05/12/2016

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