Provider Demographics
NPI:1427161413
Name:MCSWEENY, GREGORY ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALAN
Last Name:MCSWEENY
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 1:600 BLAIRS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1730
Mailing Address - Country:US
Mailing Address - Phone:319-393-3998
Mailing Address - Fax:319-393-2492
Practice Address - Street 1:600 BLAIRS FERRY RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1730
Practice Address - Country:US
Practice Address - Phone:319-393-3998
Practice Address - Fax:319-393-2492
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0067959Medicaid
IA0067959Medicaid
T88203Medicare UPIN