Most Relevant Information
Provider Data
| NPI Number: | 1003204009 |
| Provider Name: | TEGAN SWIFT RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | DI1312 |
Most Important Dates
| Enumeration Date: | 12/30/2014 |
| Last Updated: | 03/15/2021 |
Provider Practice Location
22 BRAMHALL ST
PORTLAND
ME
041023175
Practice Location Phone/Fax
| Phone: | 2076624238 |
| Fax: |
Provider Mailing Location
22 BRAMHALL ST
PORTLAND
ME
041023175
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |