Healthcare Provider Details

I. General information

NPI: 1154388320
Provider Name (Legal Business Name): LAURA SNELLENBERGER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2006
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 N SAGINAW ST
SAINT CHARLES MI
48655-1022
US

IV. Provider business mailing address

6101 RIVERVIEW RD
VASSAR MI
48768-9611
US

V. Phone/Fax

Practice location:
  • Phone: 989-865-9971
  • Fax: 989-865-6216
Mailing address:
  • Phone: 989-823-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302028146
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: