Provider Demographics
NPI:1386102325
Name:SWEDE STREET CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SWEDE STREET CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SZOSTEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-564-9185
Mailing Address - Street 1:107 E MAIN ST STE 309
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4913
Mailing Address - Country:US
Mailing Address - Phone:610-277-7520
Mailing Address - Fax:610-277-8450
Practice Address - Street 1:107 E MAIN ST STE 309
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-4913
Practice Address - Country:US
Practice Address - Phone:610-277-7520
Practice Address - Fax:610-277-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty