Healthcare Provider Details

I. General information

NPI: 1427177146
Provider Name (Legal Business Name): RACHAEL SWEENEY O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5380 ROSWELL RD NE
ATLANTA GA
30342-1916
US

IV. Provider business mailing address

5380 ROSWELL RD NE
ATLANTA GA
30342-1916
US

V. Phone/Fax

Practice location:
  • Phone: 404-250-1680
  • Fax: 404-781-8100
Mailing address:
  • Phone: 404-250-1680
  • Fax: 404-781-8100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1736
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: