Provider Demographics
NPI:1548442403
Name:SWANTON CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:SWANTON CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:STOBINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:419-826-8866
Mailing Address - Street 1:119 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558
Mailing Address - Country:US
Mailing Address - Phone:419-826-8866
Mailing Address - Fax:419-826-7290
Practice Address - Street 1:119 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558
Practice Address - Country:US
Practice Address - Phone:419-826-8866
Practice Address - Fax:419-826-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW9249751Medicare PIN
OHU65585Medicare UPIN