Healthcare Provider Details

I. General information

NPI: 1104638634
Provider Name (Legal Business Name): TYLER H SNODGRASS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 N HERMITAGE RD
HERMITAGE PA
16148-3104
US

IV. Provider business mailing address

1505 N HERMITAGE RD
HERMITAGE PA
16148-3104
US

V. Phone/Fax

Practice location:
  • Phone: 724-346-1569
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC012019
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: