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General NPI Number Information
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NPI Number | 1568819068
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Entity Type | Organization
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Legal Business Name | SWAYNE CHIROPRACTIC OFFICE, LLC
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 1560 E 61ST ST N
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City | PARK CITY
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State | KS
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Zip | 67219-1953
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Country | US
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Telephone | 785-650-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 E 61ST ST N
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City | PARK CITY
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State | KS
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Zip | 67219-1953
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Country | US
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Telephone | 785-650-2383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARLYN SWAYNE
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Credential |
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Telephone | 785-650-2383
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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 | 01-03469
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License Number State | KS
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