Provider Demographics
NPI:1124308036
Name:SWINNEY, ROCKY NEIL (LMT)
Entity type:Individual
Prefix:
First Name:ROCKY
Middle Name:NEIL
Last Name:SWINNEY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 12TH ST
Mailing Address - Street 2:SUITE 4-B
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-9497
Mailing Address - Country:US
Mailing Address - Phone:541-902-8898
Mailing Address - Fax:
Practice Address - Street 1:1525 12TH ST
Practice Address - Street 2:SUITE 4-B
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9497
Practice Address - Country:US
Practice Address - Phone:541-902-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist