Provider Demographics
NPI:1346387107
Name:SWEENEY, SARA M (DC)
Entity Type:Individual
Prefix:DR
First Name:SARA
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 1:4260 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5011
Mailing Address - Country:US
Mailing Address - Phone:770-998-8599
Mailing Address - Fax:770-998-9499
Practice Address - Street 1:4260 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5011
Practice Address - Country:US
Practice Address - Phone:770-998-8599
Practice Address - Fax:770-998-9499
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCCGXMedicare ID - Type Unspecified