Provider Demographics
NPI:1891091377
Name:NEDDO, EUGENE GLENN JR (DC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:GLENN
Last Name:NEDDO
Suffix:JR
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 1:10153 YORK RD STE 105
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3398
Mailing Address - Country:US
Mailing Address - Phone:410-628-2808
Mailing Address - Fax:410-628-2818
Practice Address - Street 1:10153 YORK RD STE 105
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3398
Practice Address - Country:US
Practice Address - Phone:410-628-2808
Practice Address - Fax:410-628-2818
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor