Provider Demographics
NPI:1104638634
Name:SNODGRASS, TYLER H (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:H
Last Name:SNODGRASS
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 1:118 VOGEL RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-3831
Mailing Address - Country:US
Mailing Address - Phone:724-822-8393
Mailing Address - Fax:
Practice Address - Street 1:118 VOGEL RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16002-3831
Practice Address - Country:US
Practice Address - Phone:724-822-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC012019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor