Provider Demographics
NPI:1942717988
Name:EUGENE NEDDO JR LLC
Entity Type:Organization
Organization Name:EUGENE NEDDO JR LLC
Other - Org Name:YORK ROAD CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:NEDDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:410-628-2808
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty