Individual
MR. WILLIAM STACEY SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ABO
Contact information
Practice address
104 S PLAZA, TAOS, NM 87571-5957
(575) 751-1565
Mailing address
104 S PLAZA, TAOS, NM 87571-5957
(575) 751-1565
(575) 751-1907
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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