Provider Demographics
NPI:1528363595
Name:SWAAGMAN, SHAWN EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:EDWARD
Last Name:SWAAGMAN
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 1:3018 ASHLAND LN S
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7774
Mailing Address - Country:US
Mailing Address - Phone:920-210-3731
Mailing Address - Fax:
Practice Address - Street 1:672 N SEMORAN BLVD
Practice Address - Street 2:STE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3350
Practice Address - Country:US
Practice Address - Phone:407-658-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor