Healthcare Provider Details

I. General information

NPI: 1609373372
Provider Name (Legal Business Name): JOSHUA CAMPBELL SWEENEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 BLUE CIRCLE DR STE 100
MINNETONKA MN
55343-9173
US

IV. Provider business mailing address

6133 BLUE CIRCLE DR STE 100
MINNETONKA MN
55343-9173
US

V. Phone/Fax

Practice location:
  • Phone: 612-888-5388
  • Fax:
Mailing address:
  • Phone: 612-888-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number6465
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: