Individual
JASON LEE SWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 STILLWATER CIR, BONAIRE, GA 31005-3857
(478) 293-1680
Mailing address
1900 WESLEYAN DR, APT 101, MACON, GA 31210-8807
(662) 312-6911
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010295
GA
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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