Healthcare Provider Details

I. General information

NPI: 1265712285
Provider Name (Legal Business Name): CHRISTINE ANNE SNYDER M.S.O.M., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 15TH AVE SUITE 102
LONGMONT CO
80501-2700
US

IV. Provider business mailing address

PO BOX 33298
NORTHGLENN CO
80233-0298
US

V. Phone/Fax

Practice location:
  • Phone: 303-651-2525
  • Fax: 303-651-2556
Mailing address:
  • Phone: 505-850-8202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1705
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: