Most Relevant Information
Provider Data
| NPI Number: | 1003178708 |
| Provider Name: | KATELIN ANN SWAN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/09/2012 |
| Last Updated: | 06/09/2012 |
Provider Practice Location
1115 W CHESTNUT ST
BROCKTON
MA
023017501
Practice Location Phone/Fax
| Phone: | 5085804691 |
| Fax: |
Provider Mailing Location
1115 W CHESTNUT ST
BROCKTON
MA
023017501
Provider Mailing Phone/Fax
| Phone: | 5085804691 |
| Fax: |