Provider Demographics
NPI:1285766287
Name:SWANSON, THOMAS JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JEAN
Last Name:SWANSON
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 1:1102 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-6284
Mailing Address - Country:US
Mailing Address - Phone:701-223-2907
Mailing Address - Fax:
Practice Address - Street 1:1102 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-6284
Practice Address - Country:US
Practice Address - Phone:701-223-2907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND441111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDT-66824OtherWORFORCE SAFETY INS
ND015298Medicaid
NDSWA4330OtherBLUE CROSS
ND015298Medicaid