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General NPI Number Information
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NPI Number | 1508287335
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Entity Type | Individual
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Provider Name | MICHAEL SEAN SWEENEY L.AC.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 1819 4TH ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-3202
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Country | US
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Telephone | 707-843-3957
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Fax | 707-523-9848
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Provider Business Mailing Address
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Address Line | PO BOX 9145
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City | SANTA ROSA
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State | CA
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Zip | 95405-1145
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Country | US
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Telephone | 707-843-3957
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Fax | 707-523-9848
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 15432
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License Number State | CA
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