Individual
MR. JOHN MICHAEL SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA CCC/SLP
Contact information
Practice address
1026 GRAND AVE, SUPERIOR, WI 54880-1755
(218) 428-9178
Mailing address
1026 GRAND AVE, SUPERIOR, WI 54880-1755
(218) 428-9178
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1605-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42563800
—
WI
Enumeration date
04/17/2008
Last updated
04/17/2008
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