Provider Demographics
NPI:1114205796
Name:SNEDDEN, CALE JACOB (DC)
Entity Type:Individual
Prefix:
First Name:CALE
Middle Name:JACOB
Last Name:SNEDDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2919
Mailing Address - Country:US
Mailing Address - Phone:740-366-6601
Mailing Address - Fax:740-366-6286
Practice Address - Street 1:340 W FAIR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130
Practice Address - Country:US
Practice Address - Phone:740-689-0199
Practice Address - Fax:740-689-0189
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0102630Medicaid
OH0102630Medicaid