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General NPI Number Information
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NPI Number | 1568288082
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Entity Type | Individual
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Provider Name | JOCELYN SWANSON LMT
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Gender | Female
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 101 W BURNSVILLE PKWY
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City | BURNSVILLE
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State | MN
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Zip | 55337-2571
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Country | US
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Telephone | 612-254-9008
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Fax |
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Provider Business Mailing Address
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Address Line | 1061 KIRKWOOD DR
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City | EAGAN
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State | MN
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Zip | 55123-1930
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Country | US
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Telephone | 612-267-9327
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | BMTL-21-8
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License Number State | MN
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