Individual
EUGENE M SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
207 N SPRING ST, BEAVER DAM, WI 53916-2115
(920) 887-8831
(920) 887-8862
Mailing address
207 N SPRING ST, BEAVER DAM, WI 53916-2115
(920) 887-8831
(920) 887-8862
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2718
MN
152W00000X
Optometrist
Primary
3067-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38631900
—
WI
05
—
490690000
—
MN
Enumeration date
02/02/2006
Last updated
02/02/2010
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