Provider Demographics
NPI:1982903399
Name:SWENSON CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SWENSON CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WOODRUFF
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-508-7246
Mailing Address - Street 1:3564 S 7200 W
Mailing Address - Street 2:SUITE D
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-3507
Mailing Address - Country:US
Mailing Address - Phone:801-508-7246
Mailing Address - Fax:801-508-1902
Practice Address - Street 1:3564 S 7200 W
Practice Address - Street 2:SUITE D
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-3507
Practice Address - Country:US
Practice Address - Phone:801-508-7246
Practice Address - Fax:801-508-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176301-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty