Individual
AUDREY M SWANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 TRUMBULL AVE, CORTLAND, OH 44410-9403
(330) 637-2000
(330) 637-2001
Mailing address
550 TRUMBULL AVE, CORTLAND, OH 44410-9403
(330) 637-2000
(330) 637-2001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004824RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
ANTHEM BCBS
OH
05
—
PENDING
—
OH
Enumeration date
11/10/2016
Last updated
11/10/2016
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