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General NPI Number Information
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NPI Number | 1063664654
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Entity Type | Organization
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Legal Business Name | SWANSON CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 420 E SAINT PATRICK ST 101
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City | RAPID CITY
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State | SD
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Zip | 57701-4202
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Country | US
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Telephone | 605-721-6510
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Fax | 605-721-6515
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Provider Business Mailing Address
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Address Line | 420 E SAINT PATRICK ST 101
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City | RAPID CITY
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State | SD
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Zip | 57701-4202
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Country | US
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Telephone | 605-721-6510
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Fax | 605-721-6515
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Authorized Official
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Title or Position | PRES.
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Name | JEFFREY S SWANSON
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Credential | DC
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Telephone | 605-721-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 975
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License Number State | SD
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