Provider Demographics
NPI:1861251654
Name:SNODGRASS, JUSTIN (NREMT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:SNODGRASS
Suffix:
Gender:M
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2098 PORTAGE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-5709
Mailing Address - Country:US
Mailing Address - Phone:330-641-0416
Mailing Address - Fax:
Practice Address - Street 1:2098 PORTAGE RD STE 350
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-5709
Practice Address - Country:US
Practice Address - Phone:330-641-0416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath