| Doctor Name: | MR. MARK RICHARD SWINNEY |
| NPI Number: | 1053664706 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSB |
| License Number: | |
| Business Practice Address: | 8 Arroyo Bonito Sandia Park, NM - 870479397 |
| Business Phone Number: | 5052507027 |
| Business Fax Number: | |
| Mailing Address: | 8 Arroyo Bonito, SANDIA PARK |
| State: | NM |
| Postal Code: | 870479397 |
| Phone Number: | 5052507027 |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2012 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 374K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Nursing Service Related Providers |
| Taxonomy Classification: | Religious Nonmedical Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A religious nonmedical practitioner offers spiritually-based care. Services may be rendered in an office, home, or care facility or by phone, email, or written correspondence. |