Provider Demographics
NPI:1871523613
Name:MCSWEENEY, LYNELLE (DC)
Entity type:Individual
Prefix:DR
First Name:LYNELLE
Middle Name:
Last Name:MCSWEENEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 RIDGEVIEW CT STE A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-6332
Mailing Address - Country:US
Mailing Address - Phone:775-525-5624
Mailing Address - Fax:775-525-3853
Practice Address - Street 1:6165 RIDGEVIEW CT STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-6332
Practice Address - Country:US
Practice Address - Phone:775-525-5624
Practice Address - Fax:775-525-3853
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29249111N00000X
NVB01461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV06952Medicare UPIN