Individual
NICHOLAS SWOBODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 CALLE LUEGO, SAN CLEMENTE, CA 92673-3065
(949) 525-1380
Mailing address
501 CALLE LUEGO, SAN CLEMENTE, CA 92673-3065
(949) 525-1380
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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