Provider Demographics
NPI:1902284409
Name:SANDY COONEY
Entity Type:Organization
Organization Name:SANDY COONEY
Other - Org Name:COONEY'S CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-494-0700
Mailing Address - Street 1:800 W PLATINUM ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2200
Mailing Address - Country:US
Mailing Address - Phone:406-494-0700
Mailing Address - Fax:406-723-2213
Practice Address - Street 1:800 W PLATINUM ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2200
Practice Address - Country:US
Practice Address - Phone:406-494-0700
Practice Address - Fax:406-723-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-1073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty