Basic Information
| Provider Information | |||||||||
| NPI: | 1760678387 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWARTZ | ||||||||
| FirstName: | TIFFANY | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | |||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ARCISZEWSKI | ||||||||
| OtherFirstName: | TIFFANY | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CMT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 47100 SCHOENHERR RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | SHELBY TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483154716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5866850505 | ||||||||
| FaxNumber: | 5866850501 | ||||||||
| Practice Location | |||||||||
| Address1: | 47100 SCHOENHERR RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | SHELBY TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483154716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5866850505 | ||||||||
| FaxNumber: | 5866850501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2007 | ||||||||
| LastUpdateDate: | 09/18/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.