Provider Demographics
NPI:1902270713
Name:SNYDER, JENA LYNN (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:JENA
Middle Name:LYNN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 410
Mailing Address - Street 2:
Mailing Address - City:LEO
Mailing Address - State:IN
Mailing Address - Zip Code:46765
Mailing Address - Country:US
Mailing Address - Phone:260-627-2276
Mailing Address - Fax:
Practice Address - Street 1:14425 LEO ROAD
Practice Address - Street 2:
Practice Address - City:LEO
Practice Address - State:IN
Practice Address - Zip Code:46765
Practice Address - Country:US
Practice Address - Phone:260-627-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002843A111N00000X
IN81000150A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist