Individual
MR. CHARLES MARVIN SWINGHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
LEBANON TREATMENT CENTER OF CRC HEALTH GROUP, 3030 CHESTNUT STREET, LEBANON, PA 17042-0000
(717) 273-8000
(717) 273-8244
Mailing address
PO BOX 146, RICHLAND, PA 17087-0146
(717) 866-6278
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN188454L
PA
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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