Individual
DEREK SWANIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14709 S BUDLONG AVE APT 309, GARDENA, CA 90247-3063
(310) 703-4072
Mailing address
14709 S BUDLONG AVE APT 309, GARDENA, CA 90247-3063
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
2472E0500X
CA
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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