Healthcare Provider Details

I. General information

NPI: 1265584049
Provider Name (Legal Business Name): ALLIED CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 E STATE ST SUITE B
FREMONT OH
43420-4365
US

IV. Provider business mailing address

1320 E STATE ST SUITE B
FREMONT OH
43420-4365
US

V. Phone/Fax

Practice location:
  • Phone: 419-332-6840
  • Fax: 419-332-6929
Mailing address:
  • Phone: 419-332-6840
  • Fax: 419-332-6929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DARREN L SNODGRASS
Title or Position: OWNER
Credential:
Phone: 419-332-6840