Provider Demographics
NPI:1336541333
Name:SWEENEY, RACHEL (OD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 UNDERWOOD FARMS BLVD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8423
Mailing Address - Country:US
Mailing Address - Phone:614-949-9676
Mailing Address - Fax:
Practice Address - Street 1:1370 UNDERWOOD FARMS BLVD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8423
Practice Address - Country:US
Practice Address - Phone:614-949-9676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6323152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist