Provider Demographics
NPI:1144613274
Name:SWANTON, JACQUELINE SUE (AT,C)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:SUE
Last Name:SWANTON
Suffix:
Gender:F
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 BARNARD ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4904
Mailing Address - Country:US
Mailing Address - Phone:989-797-6107
Mailing Address - Fax:
Practice Address - Street 1:1627 BARNARD ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4904
Practice Address - Country:US
Practice Address - Phone:989-797-6107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer