Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1648 | OH |
NPI | 1497888549 |
---|---|
Provider Name | Dr. Scott Michael Snow |
First Address | Massillon, OH 44646-9522 |
Second Address | Massillon, OH 44646-9522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U13830 | (02) | OH |