Provider Demographics
NPI:1164716890
Name:SWELEY-BUETTNER, LAURA LYNN (D C)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LYNN
Last Name:SWELEY-BUETTNER
Suffix:
Gender:F
Credentials:D C
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:SWELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1804 FORREST ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2110
Mailing Address - Country:US
Mailing Address - Phone:308-398-2255
Mailing Address - Fax:
Practice Address - Street 1:1804 FORREST ST
Practice Address - Street 2:SUITE 2
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2110
Practice Address - Country:US
Practice Address - Phone:308-398-2255
Practice Address - Fax:308-398-2256
Is Sole Proprietor?:No
Enumeration Date:2011-05-28
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor