Individual
LYNN R SWIGGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.C., L.A.T.
Contact information
Practice address
705 S UNIVERSITY AVE, SUITE 150, BEAVER DAM, WI 53916-3053
(920) 885-2663
Mailing address
207 S COLLEGE AVE, FOX LAKE, WI 53933-9414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
449-039
WI
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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