Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 21002 | CA |
NPI | 1003425539 |
---|---|
Provider Name | Erica Louise Swick |
First Address | Chula Vista, CA 91910-3141 |
Second Address | San Diego, CA 92119-3435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2020 |
Last Update Date | 30/07/2020 |