Most Relevant Information
Provider Data
| NPI Number: | 1003004664 |
| Provider Name: | ALICIA BROADWAY SWANN AUDIOLOGIST |
| Entity Type: | Individual |
| Taxonomy Code: | 231H00000X |
| Specialty: | Audiologist |
| License Number: | A0955 |
Most Important Dates
| Enumeration Date: | 10/09/2007 |
| Last Updated: | 10/23/2014 |
Provider Practice Location
541 HIGHWAY 80 W
SUITE C
CLINTON
MS
390564193
Practice Location Phone/Fax
| Phone: | 6014884189 |
| Fax: | 6014884888 |
Provider Mailing Location
541 HIGHWAY 80 W
AUDITORY PROCESSING CENTER
CLINTON
MS
390564193
Provider Mailing Phone/Fax
| Phone: | 6014884189 |
| Fax: | 6014884888 |