Provider Demographics
NPI:1194843698
Name:SWENSON, JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SWENSON
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 1:5663 IRIS CT
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-7403
Mailing Address - Country:US
Mailing Address - Phone:801-565-0631
Mailing Address - Fax:
Practice Address - Street 1:3564 S 7200 W
Practice Address - Street 2:SUITE D
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-3507
Practice Address - Country:US
Practice Address - Phone:801-508-7246
Practice Address - Fax:801-508-1902
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1763011202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor