Provider Demographics
NPI:1275088056
Name:JONATHAN P. SNOW LLC
Entity Type:Organization
Organization Name:JONATHAN P. SNOW LLC
Other - Org Name:PEAK PERFORMANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:770-591-3833
Mailing Address - Street 1:301 GOLD CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5404
Mailing Address - Country:US
Mailing Address - Phone:770-591-3833
Mailing Address - Fax:678-490-2370
Practice Address - Street 1:301 GOLD CREEK TRL
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-5404
Practice Address - Country:US
Practice Address - Phone:770-591-3833
Practice Address - Fax:678-490-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO 09074111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty