Individual
TRACEY J SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 WOODCHASE PARK DR, CLINTON, MS 39056-4113
(601) 924-7043
(601) 924-8633
Mailing address
102 WOODCHASE PARK DR, CLINTON, MS 39056-4113
(601) 924-7043
(601) 924-8633
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0153
MS
Other
Enumeration date
03/30/2010
Last updated
03/30/2010
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