MEDICARE: DR. DENNIS C SWEET D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH00002765	WA

General Provider Information

NPI Number	:	1215097977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS C SWEET D.C.

Provider Business Mailing Address
First Line	:	12919 WOODLAND AVE E
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-6303
Country	:	US
Telephone Number	:	253-770-4048
Fax Number	:

Provider Business Practice Location Address
First Line	:	8905 GRAVELLY LAKE DR SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3109
Country	:	US
Telephone Number	:	253-581-1533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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