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General NPI Number Information
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NPI Number | 1043732514
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Entity Type | Individual
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Provider Name | STANTON SWANSON MS, OTR
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Gender | Male
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Dates
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Enumeration Date | 07/16/2017
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Last Update Date | 06/09/2024
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Provider Practice Location Address
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Address Line | 305 DUNWOODY CHACE
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-4587
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Country | US
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Telephone | 678-773-9564
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Fax |
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Provider Business Mailing Address
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Address Line | 547 92ND AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-3033
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Country | US
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Telephone | 678-773-9564
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | OT24976
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT006296
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License Number State | GA
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