Individual
CARLY ZOE SWETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(760) 937-1852
Mailing address
2227 GALLOWAY AVE, BISHOP, CA 93514-2017
(760) 937-1852
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9986
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2019
Last updated
10/02/2020
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