Provider Demographics
NPI:1104003706
Name:SWINFORD, SANDRA JEAN
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEAN
Last Name:SWINFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JEAN
Other - Last Name:PLUMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6019
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41022-6019
Mailing Address - Country:US
Mailing Address - Phone:859-525-2907
Mailing Address - Fax:
Practice Address - Street 1:3 E COBBLESTONE CT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-9419
Practice Address - Country:US
Practice Address - Phone:859-525-2907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor