Provider Demographics
NPI:1508286428
Name:SWANLUND, MEGAN ASHLEY (ATC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ASHLEY
Last Name:SWANLUND
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 LE POINT ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2713
Mailing Address - Country:US
Mailing Address - Phone:805-208-7457
Mailing Address - Fax:
Practice Address - Street 1:1106 WALNUT ST # 110
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2416
Practice Address - Country:US
Practice Address - Phone:805-235-4672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer