Provider Demographics
NPI:1306175112
Name:SWEENEY, JENNIFER M (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9479 GARLAND LANE N.
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-5480
Mailing Address - Country:US
Mailing Address - Phone:763-494-8787
Mailing Address - Fax:763-494-8841
Practice Address - Street 1:11031 TERRITORIAL TRL
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-2870
Practice Address - Country:US
Practice Address - Phone:763-772-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor