Healthcare Provider Details

I. General information

NPI: 1225033632
Provider Name (Legal Business Name): JOHN J SNYDER II D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/17/2006
Reactivation Date: 03/22/2006

III. Provider practice location address

649 WALNUT ST
COSHOCTON OH
43812-1634
US

IV. Provider business mailing address

649 WALNUT ST
COSHOCTON OH
43812-1634
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-3677
  • Fax: 740-622-3631
Mailing address:
  • Phone: 740-622-3677
  • Fax: 740-622-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number954
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: