MEDICARE: MR. DARREN L SNODGRASS DC

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	2985	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427040484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DARREN L SNODGRASS DC

Provider Business Mailing Address
First Line	:	1320 E STATE ST
Second Line	:	STE B
City	:	FREMONT
State	:	OH
Zip	:	43420-4365
Country	:	US
Telephone Number	:	419-332-6840
Fax Number	:	419-332-6929

Provider Business Practice Location Address
First Line	:	1320 E STATE ST
Second Line	:	STE B
City	:	FREMONT
State	:	OH
Zip	:	43420-4365
Country	:	US
Telephone Number	:	419-332-6840
Fax Number	:	419-332-6929

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/08/2007

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Directions to “ MR. DARREN L SNODGRASS DC” Practice Location

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