Doctor Name: | MR. KELSEY K SWOPE |
NPI Number: | 1023248531 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CMT |
License Number: | MT20900386 |
Business Practice Address: | 235 E Mckinley Ave., Suite 4 Mishawaka, IN - 465456260 |
Business Phone Number: | 5742593323 |
Business Fax Number: | 5742593323 |
Mailing Address: | 235 E Mckinley Ave., Suite 4, MISHAWAKA |
State: | IN |
Postal Code: | 465456260 |
Phone Number: | 5742593323 |
Fax Number: | 5742593323 |
NPI Enumeration Date: | 07/17/2009 |
NPI Last Update Date: | 07/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT20900386 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |