Provider Demographics
NPI:1972378412
Name:SWALLOW, MARK (CHIROPRACTOR)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SWALLOW
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4726
Mailing Address - Country:US
Mailing Address - Phone:610-678-8600
Mailing Address - Fax:
Practice Address - Street 1:3301 SCHOOLHOUSE LN
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4726
Practice Address - Country:US
Practice Address - Phone:610-678-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty