Provider Demographics
NPI:1053551184
Name:TODATRY, SWARUPA (NCTM)
Entity type:Individual
Prefix:
First Name:SWARUPA
Middle Name:
Last Name:TODATRY
Suffix:
Gender:F
Credentials:NCTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2118
Mailing Address - Country:US
Mailing Address - Phone:630-305-8107
Mailing Address - Fax:
Practice Address - Street 1:1160 REDFIELD RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2118
Practice Address - Country:US
Practice Address - Phone:630-305-8107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist