Individual
MR. EDGAR EARL SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
137 W BROADWAY, GALLATIN, TN 37066-2717
(615) 452-2111
(615) 452-2251
Mailing address
137 W BROADWAY, GALLATIN, TN 37066-2717
(615) 452-2111
(615) 452-2251
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DPO0000000657
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43794
—
TN
Enumeration date
08/01/2006
Last updated
08/29/2007
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