Provider Demographics
NPI:1134190812
Name:SNOOK, RICKEY LEE (DC)
Entity type:Individual
Prefix:DR
First Name:RICKEY
Middle Name:LEE
Last Name:SNOOK
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 1:1796 WHITE OAK RD
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17579-9406
Mailing Address - Country:US
Mailing Address - Phone:717-786-9094
Mailing Address - Fax:717-786-5193
Practice Address - Street 1:23 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANA
Practice Address - State:PA
Practice Address - Zip Code:17509-9504
Practice Address - Country:US
Practice Address - Phone:717-786-1777
Practice Address - Fax:717-786-5193
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002334L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASN1618842OtherHIGH MARK BLUE SHEILD
PA02638700OtherCAPITAL BLUE CROSS
PA1031375OtherASHN
PA1031375OtherASHN
PA02638700OtherCAPITAL BLUE CROSS