Provider Demographics
NPI:1558651612
Name:SWANN CHIROPRACTIC
Entity Type:Organization
Organization Name:SWANN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SWANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-893-3300
Mailing Address - Street 1:1425 S MOORE RD STE D
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-2836
Mailing Address - Country:US
Mailing Address - Phone:423-893-3300
Mailing Address - Fax:423-893-3363
Practice Address - Street 1:1425 S MOORE RD STE D
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-2836
Practice Address - Country:US
Practice Address - Phone:423-893-3300
Practice Address - Fax:423-893-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001495332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU73934Medicare PIN