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General NPI Number Information
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NPI Number | 1932523131
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Entity Type | Organization
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Legal Business Name | SWEENEY WELLNESS LLC
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 8005 MACKENZIE RD
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City | AFFTON
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State | MO
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Zip | 63123-3518
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Country | US
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Telephone | 314-353-4500
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Fax | 314-353-4502
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Provider Business Mailing Address
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Address Line | 902 PALM BAY DR
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City | BALLWIN
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State | MO
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Zip | 63021-7936
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Country | US
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Telephone | 314-651-5705
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ALEXANDRA LINDSEY SWEENEY
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Credential | DC
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Telephone | 314-651-5705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2014002029
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License Number State | MO
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