Individual
DR. SUSAN SWETNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
324 S 5TH AVE, POCATELLO, ID 83201-5803
(208) 339-1130
Mailing address
9388 W CHARLOTTE DR, POCATELLO, ID 83204-7210
(208) 339-1130
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MASG-2171
ID
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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