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General NPI Number Information
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NPI Number | 1881749059
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Entity Type | Organization
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Legal Business Name | SWANSON FAMILY CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4010 W 65TH ST SUITE 123
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City | EDINA
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State | MN
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Zip | 55435-1721
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Country | US
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Telephone | 952-922-9513
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Fax | 952-922-8469
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Provider Business Mailing Address
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Address Line | 4010 W 65TH ST SUITE 123
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City | EDINA
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State | MN
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Zip | 55435-1721
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Country | US
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Telephone | 952-922-9513
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Fax | 952-922-8469
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARA SWANSON
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Credential | D.C.
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Telephone | 952-922-9513
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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 | 4131
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License Number State | MN
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