Individual
KARL SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10782 SOUTH US HWY 1, PORT SAINT LUCIE, FL 34952
(772) 370-1978
Mailing address
10782 SOUTH US HWY 1, PORT SAINT LUCIE, FL 34952
(772) 370-1978
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA41660
FL
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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