# OLD DOMINION OSTEOPATHIC MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659623205
- **Authorized official:** DR. JASON SNEED D.O. (MEMBER/MANAGER)
- **Authorized official phone:** (703) 505-2620

## Contact information

- **Practice address:** 2525 COWAN BLVD, FREDERICKSBURG, VA 22401-8440
- **Practice address phone:** (540) 423-6858
- **Mailing address:** 2525 COWAN BLVD, FREDERICKSBURG, VA 22401-8440
- **Mailing address phone:** (540) 423-6858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 0102202984 | VA | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 03/05/2013