Individual
MR. MICHAEL JARETH SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2402 FRIST BLVD, SUITE 204, FORT PIERCE, FL 34950-4838
(772) 462-3939
(772) 462-3938
Mailing address
2402 FRIST BLVD, SUITE 204, FORT PIERCE, FL 34950-4838
(772) 462-3939
(772) 462-3938
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9108363
FL
Other
Enumeration date
10/27/2014
Last updated
04/13/2015
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