Provider Demographics
NPI:1215011630
Name:SWINEY, DAVID GLENN (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GLENN
Last Name:SWINEY
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 1:260 S 1ST ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1602
Mailing Address - Country:US
Mailing Address - Phone:317-506-6633
Mailing Address - Fax:317-663-0895
Practice Address - Street 1:260 S 1ST ST
Practice Address - Street 2:SUITE 5
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1602
Practice Address - Country:US
Practice Address - Phone:317-506-6633
Practice Address - Fax:317-663-0895
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556166111N00000X
IN08002400A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V406S21Medicare ID - Type Unspecified
VAU95470Medicare UPIN