Provider Demographics
NPI:1265792626
Name:SWANN, CASEY ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:ELIZABETH
Last Name:SWANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LONGRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1416
Mailing Address - Country:US
Mailing Address - Phone:914-772-8685
Mailing Address - Fax:
Practice Address - Street 1:9 LONGRIDGE TRL
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-1416
Practice Address - Country:US
Practice Address - Phone:914-772-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-20
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70012183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor