Individual
CHARLES HOLBROOK SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1712 GREENTREE RD, ENCINITAS, CA 92024-3022
(760) 613-8719
Mailing address
1712 GREENTREE RD, ENCINITAS, CA 92024-3022
(760) 613-8719
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4922
CA
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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