Provider Demographics
NPI:1427099605
Name:SCHRAD-SWANK, JULIE A (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:SCHRAD-SWANK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:SCHRAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1120 W DAVIES ST
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-1064
Mailing Address - Country:US
Mailing Address - Phone:563-285-5348
Mailing Address - Fax:
Practice Address - Street 1:1120 W DAVIES ST
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1064
Practice Address - Country:US
Practice Address - Phone:563-285-5348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00044OtherBLUE CROSS BLUE SHIELD
IAT38422Medicare UPIN
IA00044Medicare ID - Type Unspecified