Individual
ROBERT LYLE SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5050 SUMMIT AVE, EAST SAINT LOUIS, IL 62203-1026
(618) 874-3597
(618) 874-8212
Mailing address
5050 SUMMIT AVE, EAST SAINT LOUIS, IL 62203-1026
(618) 874-3597
(618) 874-8212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001811
IL
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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