Healthcare Provider Details

I. General information

NPI: 1083852909
Provider Name (Legal Business Name): SNYDER BRACE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 I 70 DR SE SUITE 104
COLUMBIA MO
65201-6522
US

IV. Provider business mailing address

3700 I 70 DR SE SUITE 104
COLUMBIA MO
65201-6522
US

V. Phone/Fax

Practice location:
  • Phone: 573-442-7223
  • Fax: 573-442-7224
Mailing address:
  • Phone: 573-442-7223
  • Fax: 573-442-7224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. LYNNE SUZANNE SNYDER
Title or Position: OWNER/CERTIFIED ORTHOTIST
Credential: CO
Phone: 573-239-6069