Provider Demographics
NPI:1679504385
Name:SWANSON, WENDY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:LYNN
Last Name:SWANSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 ASHWOOD RD
Mailing Address - Street 2:APARTMENT 205
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1290
Mailing Address - Country:US
Mailing Address - Phone:651-592-2948
Mailing Address - Fax:
Practice Address - Street 1:2597 EAST 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109
Practice Address - Country:US
Practice Address - Phone:651-777-1710
Practice Address - Fax:651-777-9108
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor