Provider Demographics
NPI:1841410248
Name:ERICK C SWENSON D.C., P.A.
Entity Type:Organization
Organization Name:ERICK C SWENSON D.C., P.A.
Other - Org Name:SWENSON CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-770-7938
Mailing Address - Street 1:2485 MAPLEWOOD DRIVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109
Mailing Address - Country:US
Mailing Address - Phone:651-770-7938
Mailing Address - Fax:
Practice Address - Street 1:2485 MAPLEWOOD DRIVE
Practice Address - Street 2:SUITE 215
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109
Practice Address - Country:US
Practice Address - Phone:651-770-7938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty