Provider Demographics
NPI:1467519207
Name:COONEY, SANDY JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:JEAN
Last Name:COONEY
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 1:800 W PLATINUM ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2200
Mailing Address - Country:US
Mailing Address - Phone:406-494-0700
Mailing Address - Fax:406-723-2213
Practice Address - Street 1:800 W PLATINUM ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2200
Practice Address - Country:US
Practice Address - Phone:406-494-0700
Practice Address - Fax:406-723-2213
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41043OtherBLUE CROSS BLUE SHIELD
MT41043OtherBLUE CROSS BLUE SHIELD