Healthcare Provider Details

I. General information

NPI: 1558482554
Provider Name (Legal Business Name): HARTFORD SPINAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 WEST HIGHWAY 38 SUITE 122
HARTFORD SD
57033
US

IV. Provider business mailing address

PO BOX 446
HARTFORD SD
57033-0446
US

V. Phone/Fax

Practice location:
  • Phone: 605-528-6240
  • Fax:
Mailing address:
  • Phone: 605-528-6240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JAYSON DALE SNYDER
Title or Position: PRESIDENT
Credential: DC
Phone: 605-528-6240