MEDICARE: SWANK CHIROPRACTIC CENTER, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1751	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08532	OTHER	NC	BCBSNC

General Provider Information

NPI Number	:	1053477190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWANK CHIROPRACTIC CENTER, P.A.

Provider Business Mailing Address
First Line	:	3731 NW CARY PKWY
Second Line	:	SUITE 101
City	:	CARY
State	:	NC
Zip	:	27513-8436
Country	:	US
Telephone Number	:	919-460-6098
Fax Number	:	919-460-6099

Provider Business Practice Location Address
First Line	:	3731 NW CARY PKWY
Second Line	:	SUITE 101
City	:	CARY
State	:	NC
Zip	:	27513-8436
Country	:	US
Telephone Number	:	919-460-6098
Fax Number	:	919-460-6099

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. TIMOTHY ALLEN SWANK
Credential	:	D.C.
Telephone Number	:	919-460-6098

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	07/23/2010

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Directions to “SWANK CHIROPRACTIC CENTER, P.A. ” Practice Location

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