Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1428 | MA |
NPI | 1649357963 |
---|---|
Provider Name | Dr. David Mark Swensen |
First Address | Melrose, MA 02176-3811 |
Second Address | Melrose, MA 02176-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 17/02/2020 |