Provider Demographics
NPI:1134104235
Name:SWEDBERG, ALFRED WARNER JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:WARNER
Last Name:SWEDBERG
Suffix:JR
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 1:3705 WESTERFELD DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3462
Mailing Address - Country:US
Mailing Address - Phone:505-275-6708
Mailing Address - Fax:505-275-6725
Practice Address - Street 1:3705 WESTERFELD DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3462
Practice Address - Country:US
Practice Address - Phone:505-275-6708
Practice Address - Fax:505-275-6725
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMU85648Medicare UPIN