Provider Demographics
NPI:1669834644
Name:SWENSON, BECKY (CMT)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-4496
Mailing Address - Country:US
Mailing Address - Phone:507-340-3195
Mailing Address - Fax:
Practice Address - Street 1:530 N RIVERFRONT DR # DT
Practice Address - Street 2:SUIE 130
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3449
Practice Address - Country:US
Practice Address - Phone:507-388-1229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist