Healthcare Provider Details

I. General information

NPI: 1174457576
Provider Name (Legal Business Name): MARIA MOLAN SNODGRASS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1643 LITITZ PIKE
LANCASTER PA
17601-6507
US

IV. Provider business mailing address

1643 LITITZ PIKE
LANCASTER PA
17601-6507
US

V. Phone/Fax

Practice location:
  • Phone: 717-391-7660
  • Fax:
Mailing address:
  • Phone: 717-391-7660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG004374
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: