Provider Demographics
NPI:1396747770
Name:SWAILES, DUANE JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:JOHN
Last Name:SWAILES
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:P.O. BOX 266
Mailing Address - Street 2:917 PARROTT ST
Mailing Address - City:APLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:50604-0266
Mailing Address - Country:US
Mailing Address - Phone:319-347-2313
Mailing Address - Fax:319-347-2313
Practice Address - Street 1:917 PARROTT ST
Practice Address - Street 2:
Practice Address - City:APLINGTON
Practice Address - State:IA
Practice Address - Zip Code:50604-0266
Practice Address - Country:US
Practice Address - Phone:319-347-2313
Practice Address - Fax:319-347-2313
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0124974Medicaid
IA0124974Medicaid
IA12497Medicare ID - Type Unspecified
12497Medicare PIN