Healthcare Provider Details

I. General information

NPI: 1265564595
Provider Name (Legal Business Name): ELVIRA T SNYDER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELVIRA BITA HLAVATY DC

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E ALVARADO ST
FALLBROOK CA
92028-2303
US

IV. Provider business mailing address

925 E ALVARADO ST
FALLBROOK CA
92028-2303
US

V. Phone/Fax

Practice location:
  • Phone: 760-728-9229
  • Fax:
Mailing address:
  • Phone: 760-728-9229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC17493
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: