Provider Demographics
NPI:1114089877
Name:SWOBODA CHIROPRACTIC OF LAKEFIELD
Entity type:Organization
Organization Name:SWOBODA CHIROPRACTIC OF LAKEFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWOBODA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:507-662-5176
Mailing Address - Street 1:221 THIRD AVE N
Mailing Address - Street 2:PO BOX 758
Mailing Address - City:LAKEFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:56150-0758
Mailing Address - Country:US
Mailing Address - Phone:507-662-5176
Mailing Address - Fax:507-662-5178
Practice Address - Street 1:221 THIRD AVE N
Practice Address - Street 2:
Practice Address - City:LAKEFIELD
Practice Address - State:MN
Practice Address - Zip Code:56150-0758
Practice Address - Country:US
Practice Address - Phone:507-662-5176
Practice Address - Fax:507-662-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FM27826OtherSIOUX VALLEY HEALTH PARTN
MN36B24LAOtherBCBS OF MN
MN36B25SWOtherBCBS OFFICE
MN36B24LAOtherBCBS OF MN
FM27826OtherSIOUX VALLEY HEALTH PARTN