Organization Name: | SWICK & JONES PEDORTHIC LAB, LLC |
NPI Number: | 1932135415 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | REGINA M SWICKARD (OWNER) |
Mailing Address: | 617 Watervliet Ave Dayton |
State: | OH US |
Postal Code: | 454202544 |
Phone Number: | 9372563668 |
Fax Number: | 9372561650 |
NPI Enumeration Date: | 06/24/2006 |
NPI Last Update Date: | 02/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | LPED-0051 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |