Healthcare Provider Details

I. General information

NPI: 1134646326
Provider Name (Legal Business Name): SNAP CHIROPRACTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 WILLIAM THOMASON BYU
LEITCHFIELD KY
42754-1402
US

IV. Provider business mailing address

214 WILLIAM THOMASON BYU
LEITCHFIELD KY
42754-1402
US

V. Phone/Fax

Practice location:
  • Phone: 270-832-8355
  • Fax: 270-971-1451
Mailing address:
  • Phone: 270-832-8355
  • Fax: 270-971-1451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5262
License Number StateKY

VIII. Authorized Official

Name: DR. CRAIG MATTHEW CHENEY
Title or Position: DC
Credential:
Phone: 270-832-8355