Provider Demographics
NPI:1508996158
Name:SNYDER, JONATHAN MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:SNYDER
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 1:133 WATT STREET
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113
Mailing Address - Country:US
Mailing Address - Phone:740-474-2273
Mailing Address - Fax:740-474-2273
Practice Address - Street 1:133 WATT ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1746
Practice Address - Country:US
Practice Address - Phone:740-474-2273
Practice Address - Fax:740-474-2273
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2539097Medicaid
OH2539097Medicaid