Provider Demographics
NPI:1790151934
Name:SWEENEY, BRIAN G (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:G
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1997
Mailing Address - Country:US
Mailing Address - Phone:814-283-5432
Mailing Address - Fax:
Practice Address - Street 1:1800 N JUNIATA ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1997
Practice Address - Country:US
Practice Address - Phone:814-283-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0265172251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT026517OtherSTATE LICENSE