Provider Demographics
NPI:1538681853
Name:SWEENEY, JORDAN MICHAEL (ATS)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:MICHAEL
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 WARD ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2428
Mailing Address - Country:US
Mailing Address - Phone:570-687-7057
Mailing Address - Fax:
Practice Address - Street 1:1441 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1864
Practice Address - Country:US
Practice Address - Phone:610-625-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer