Provider Demographics
NPI:1245604305
Name:SWEENEY, RONALD JUSTIN (DC, FASA)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JUSTIN
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:DC, FASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 N MUR-LEN RD
Mailing Address - Street 2:STE B
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1220
Mailing Address - Country:US
Mailing Address - Phone:913-839-2389
Mailing Address - Fax:913-839-2298
Practice Address - Street 1:531 N MUR LEN RD STE B
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062
Practice Address - Country:US
Practice Address - Phone:913-839-2389
Practice Address - Fax:913-839-2298
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016005840111N00000X
KS01-05755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor