Individual
KYLE SWANSON
Active
Individual
KYLE SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126002025
VA
225X00000X
Occupational Therapist
Primary
OC018314
PA
Other
Enumeration date
12/04/2014
Last updated
12/05/2022
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