Provider Demographics
NPI:1962795252
Name:JONATHAN SNOW PLLC
Entity type:Organization
Organization Name:JONATHAN SNOW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:801-400-5564
Mailing Address - Street 1:2230 N UNIVERSITY PKWY
Mailing Address - Street 2:STE. 6B
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1509
Mailing Address - Country:US
Mailing Address - Phone:801-235-9944
Mailing Address - Fax:801-235-9955
Practice Address - Street 1:2230 N UNIVERSITY PKWY
Practice Address - Street 2:STE. 6B
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1509
Practice Address - Country:US
Practice Address - Phone:801-235-9944
Practice Address - Fax:801-235-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6430440-1202111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty