Individual
DEREK HAROLD SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1894 37TH ST SE, SAINT CLOUD, MN 56304-9508
(612) 708-3059
Mailing address
PO BOX 953, BRAINERD, MN 56401-0953
(612) 708-3059
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
CO
225100000X
Physical Therapist
—
MN
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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