| Doctor Name: | MRS. SANDRA GRACE SWAL |
| NPI Number: | 1013172410 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN - CDE |
| License Number: | R-100672 |
| Business Practice Address: | 4303 Live Oak Dr Little River, SC - 295669138 |
| Business Phone Number: | 8432493424 |
| Business Fax Number: | 8432495891 |
| Mailing Address: | 4303 Live Oak Dr, LITTLE RIVER |
| State: | SC |
| Postal Code: | 295669138 |
| Phone Number: | 8432493424 |
| Fax Number: | 8432495891 |
| NPI Enumeration Date: | 07/24/2008 |
| NPI Last Update Date: | 07/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | R-100672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |