Provider Demographics
NPI:1942331350
Name:SNIPES, J. ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:J. ERIC
Middle Name:
Last Name:SNIPES
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 1:611 LOUISA ST
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-2112
Mailing Address - Country:US
Mailing Address - Phone:318-728-9812
Mailing Address - Fax:318-728-0419
Practice Address - Street 1:611 LOUISA ST
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-2112
Practice Address - Country:US
Practice Address - Phone:318-728-9812
Practice Address - Fax:318-728-0419
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor