MEDICARE: SNYDER VISION OPTOMETRISTS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2880	MN

General Provider Information

NPI Number	:	1407088305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNYDER VISION OPTOMETRISTS PLLC

Provider Business Mailing Address
First Line	:	757 CLEVELAND AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1302
Country	:	US
Telephone Number	:	651-699-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 CLEVELAND AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1302
Country	:	US
Telephone Number	:	651-699-5400
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN J SNYDER
Credential	:	O.D.
Telephone Number	:	612-619-6038

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	02/19/2015

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