Provider Demographics
NPI:1659880359
Name:SWENSON, LINDSAY (OD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14617 W LAWYERS RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-3219
Mailing Address - Country:US
Mailing Address - Phone:704-893-0090
Mailing Address - Fax:704-893-0944
Practice Address - Street 1:14617 W LAWYERS RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-3219
Practice Address - Country:US
Practice Address - Phone:704-893-0090
Practice Address - Fax:704-893-0944
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5251152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist