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General NPI Number Information
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NPI Number | 1407088305
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Entity Type | Organization
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Legal Business Name | SNYDER VISION OPTOMETRISTS PLLC
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 757 CLEVELAND AVE S
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City | SAINT PAUL
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State | MN
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Zip | 55116-1302
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Country | US
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Telephone | 651-699-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 757 CLEVELAND AVE S
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City | SAINT PAUL
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State | MN
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Zip | 55116-1302
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Country | US
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Telephone | 651-699-5400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN J SNYDER
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Credential | O.D.
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Telephone | 612-619-6038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2880
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License Number State | MN
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