Provider Demographics
NPI:1053477190
Name:SWANK CHIROPRACTIC CENTER, P.A.
Entity Type:Organization
Organization Name:SWANK CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SWANK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-460-6098
Mailing Address - Street 1:3731 NW CARY PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8436
Mailing Address - Country:US
Mailing Address - Phone:919-460-6098
Mailing Address - Fax:919-460-6099
Practice Address - Street 1:3731 NW CARY PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8436
Practice Address - Country:US
Practice Address - Phone:919-460-6098
Practice Address - Fax:919-460-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-30
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08532OtherBCBSNC
NC08532OtherBCBSNC
NCT93024Medicare UPIN