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Individual

CLIFFORD DANIEL THOMAS SWANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1805 VERNON RD, LAGRANGE, GA 30240-3871
(706) 710-9723
Mailing address
1063 PRIDDY RD, LAGRANGE, GA 30241-9604
(706) 885-2881

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004873
GA
225200000X
Physical Therapy Assistant
PTA10782
AL

Other

Enumeration date
03/15/2023
Last updated
03/15/2023
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