Provider Demographics
NPI:1235375049
Name:WASWICK CHIROPRACTIC
Entity Type:Organization
Organization Name:WASWICK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:WASWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-678-2431
Mailing Address - Street 1:10 N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:GWINNER
Mailing Address - State:ND
Mailing Address - Zip Code:58040-0147
Mailing Address - Country:US
Mailing Address - Phone:701-678-2431
Mailing Address - Fax:
Practice Address - Street 1:10 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:GWINNER
Practice Address - State:ND
Practice Address - Zip Code:58040
Practice Address - Country:US
Practice Address - Phone:701-678-2431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDT78417OtherWORKFORCE SAFETY INSURANCE
ND17793Medicaid
ND14257Medicaid
ND19602OtherBLUE CROSS BLUE SHIELD
NDN11879Medicare UPIN