=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225224785
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFREY M SNYDER D C INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2007
-----------------------------------------------------
Last Update Date | 03/26/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 234 N PLAZA BLVD
-----------------------------------------------------
City | CHILLICOTHEE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45601-1798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-772-2273
-----------------------------------------------------
Fax | 740-772-2274
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 234 N PLAZA BLVD
-----------------------------------------------------
City | CHILLICOTHEE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45601-1798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-772-2273
-----------------------------------------------------
Fax | 740-772-2274
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JEFFREY M SNYDER
-----------------------------------------------------
Credential | D C
-----------------------------------------------------
Telephone | 740-772-2273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------