Provider Demographics
NPI:1699071456
Name:SCHWENN, MICHELLE DAWN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DAWN
Last Name:SCHWENN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LINCOLN AVE
Mailing Address - Street 2:UNIT F
Mailing Address - City:LISBON
Mailing Address - State:IA
Mailing Address - Zip Code:52253-9660
Mailing Address - Country:US
Mailing Address - Phone:563-528-2329
Mailing Address - Fax:
Practice Address - Street 1:5475 DYER AVE
Practice Address - Street 2:SUITE 151
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-8963
Practice Address - Country:US
Practice Address - Phone:563-528-2329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor