Healthcare Provider Details
I. General information
NPI: 1639113913
Provider Name (Legal Business Name): SNOOK CHIROPRACTIC AND NUTRITION CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23 LANCASTER AVE
CHRISTIANA PA
17509-9504
US
IV. Provider business mailing address
PO BOX 145
BART PA
17503-0145
US
V. Phone/Fax
- Phone: 717-786-1777
- Fax: 717-786-5193
- Phone: 717-786-1777
- Fax: 717-786-5193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | DC002334L |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
RICKEY
L
SNOOK
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 717-786-1777