Provider Demographics
NPI:1134646326
Name:SNAP CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:SNAP CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:CHENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-832-8355
Mailing Address - Street 1:214 WILLIAM THOMASON BYU
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-1402
Mailing Address - Country:US
Mailing Address - Phone:270-832-8355
Mailing Address - Fax:270-971-1451
Practice Address - Street 1:214 WILLIAM THOMASON BYU
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-1402
Practice Address - Country:US
Practice Address - Phone:270-832-8355
Practice Address - Fax:270-971-1451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SNAP CHIROPRACTIC CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5262OtherKENTUCKY LICENSE NUMBER