Provider Demographics
NPI:1003231176
Name:SWANSON, NOAH CURTIS (DC)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:CURTIS
Last Name:SWANSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 HOLLISTER RANCH RD
Mailing Address - Street 2:
Mailing Address - City:GAVIOTA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-9753
Mailing Address - Country:US
Mailing Address - Phone:905-451-2844
Mailing Address - Fax:
Practice Address - Street 1:69 HOLLISTER RANCH RD
Practice Address - Street 2:
Practice Address - City:GAVIOTA
Practice Address - State:CA
Practice Address - Zip Code:93117-9753
Practice Address - Country:US
Practice Address - Phone:805-451-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor