Individual
MR. THEREN SWINFORD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LMT, LAT
Contact information
Practice address
255 S MARCO WAY, SATELLITE BEACH, FL 32937-3453
(202) 302-9860
Mailing address
255 S MARCO WAY, SATELLITE BEACH, FL 32937-3453
(202) 302-9860
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2259
FL
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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