Organization
FUNCTIONAL COGNITION CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANTON SWANSON OTD (OWNER)
(678) 773-9564
Entity
Organization
Contact information
Practice address
547 92ND AVE N, SAINT PETERSBURG, FL 33702-3033
(678) 773-9564
Mailing address
547 92ND AVE N, SAINT PETERSBURG, FL 33702-3033
(678) 773-9564
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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