Healthcare Provider Details

I. General information

NPI: 1508896655
Provider Name (Legal Business Name): ALVIN RAY SCHWERDTFAGER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 N MAIN ST
LINDSBORG KS
67456-2227
US

IV. Provider business mailing address

136 N MAIN ST
LINDSBORG KS
67456-2227
US

V. Phone/Fax

Practice location:
  • Phone: 785-227-2633
  • Fax: 785-227-4193
Mailing address:
  • Phone: 785-227-2633
  • Fax: 785-227-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01-03688
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number01-03688
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: