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General NPI Number Information
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NPI Number | 1134262280
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Entity Type | Individual
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Provider Name | JUSTIN FORREST SWANN DC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 613 13TH ST.
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City | ASHLAND
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State | KY
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Zip | 41101-2669
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Country | US
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Telephone | 606-329-8080
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Fax | 606-325-8550
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Provider Business Mailing Address
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Address Line | 613 13TH ST
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City | ASHLAND
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State | KY
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Zip | 41101-2617
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Country | US
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Telephone | 606-329-8080
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Fax | 606-325-8550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4525
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License Number State | KY
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