Provider Demographics
NPI:1649357963
Name:SWENSEN, DAVID MARK (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:SWENSEN
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 1:40 W FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3811
Mailing Address - Country:US
Mailing Address - Phone:781-665-1497
Mailing Address - Fax:781-662-7111
Practice Address - Street 1:653 MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3101
Practice Address - Country:US
Practice Address - Phone:781-665-1497
Practice Address - Fax:781-662-7111
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1428111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35987Medicare ID - Type Unspecified