Provider Demographics
NPI:1740624147
Name:SWEAT, MIGNON (MS, DC)
Entity type:Individual
Prefix:DR
First Name:MIGNON
Middle Name:
Last Name:SWEAT
Suffix:
Gender:F
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 SHADRACK ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-1540
Mailing Address - Country:US
Mailing Address - Phone:706-437-1170
Mailing Address - Fax:706-437-1163
Practice Address - Street 1:403 SHADRACK ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-1540
Practice Address - Country:US
Practice Address - Phone:706-437-1170
Practice Address - Fax:706-437-1163
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor