Provider Demographics
NPI:1154590297
Name:SWOLENSKY CHIROPRACTIC LTD
Entity type:Organization
Organization Name:SWOLENSKY CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWOLENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-565-7474
Mailing Address - Street 1:718 S BOULDER HWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7589
Mailing Address - Country:US
Mailing Address - Phone:702-565-7474
Mailing Address - Fax:702-565-1262
Practice Address - Street 1:718 S BOULDER HWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7589
Practice Address - Country:US
Practice Address - Phone:702-565-7474
Practice Address - Fax:702-565-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV1977OtherBLUE CROSS/BLUE SHIELD
NVU71588Medicare UPIN
NV31255Medicare PIN