Swanson, Shad Leroy

Swanson, Shad Leroy is an individual health care provider with primary practice located at 403 America Ave Nw , Bemidji MN 56601-3122. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Swanson, Shad Leroy can be contacted via phone (218) 444-8727.

Contact Information

Primary practice address
403 America Ave Nw Bemidji MN 56601-3122
Phone: (218) 444-8727
Fax: (218) 444-8546
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 4040 Minnesota

Profile Details

NPI number 1558368209
LBN Legal business name Swanson, Shad Leroy
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Dec 4th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558368209 NPPES
Minnesota MEDICAID 122393300
Minnesota Other 219G4SW

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