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NPI Code Detail

MEDICARE: REGG SWANSON AT

MEDICARE: REGG SWANSON AT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer45TN

General Provider Information

NPI Number : 1881700623
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGG SWANSON AT
Provider Business Mailing Address
First Line : PO BOX 681478
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-1478
Country : US
Telephone Number : 866-800-9147
Fax Number : 615-591-6601
Provider Business Practice Location Address
First Line : 211 BEDFORD WAY
Second Line :
City : FRANKLIN
State : TN
Zip : 37064-5527
Country : US
Telephone Number : 615-591-8480
Fax Number : 615-791-0989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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