Individual
MR. JEREMEY WAYNE SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
7700 HUDSON RD, SUITE 600, WOODBURY, MN 55125-1490
(651) 731-0037
(651) 731-6986
Mailing address
37 WINDSOR WOOD PATH, HUDSON, WI 54016-7772
(651) 755-8406
(651) 731-6986
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
302519
MN
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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