Provider Demographics
NPI:1184213209
Name:SWAT CHIROPRACTIC & REHAB INC.
Entity Type:Organization
Organization Name:SWAT CHIROPRACTIC & REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWATZKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-661-3639
Mailing Address - Street 1:2102 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4901
Mailing Address - Country:US
Mailing Address - Phone:605-661-3639
Mailing Address - Fax:
Practice Address - Street 1:800 MARINER LN STE 103
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-6848
Practice Address - Country:US
Practice Address - Phone:605-661-3639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1497343883Medicaid