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General NPI Number Information
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NPI Number | 1578706966
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Entity Type | Organization
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Legal Business Name | RICHARD P. SNYDER, O.D.
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 88267 N TERRITORIAL RD
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City | VENETA
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State | OR
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Zip | 97487-9499
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Country | US
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Telephone | 541-935-3332
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Fax | 541-935-5710
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Provider Business Mailing Address
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Address Line | PO BOX 159
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City | VENETA
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State | OR
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Zip | 97487-0159
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Country | US
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Telephone | 541-935-3332
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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. RICHARD PAUL SNYDER
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Credential | O.D.
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Telephone | 541-935-3332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 1510ATI
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License Number State | OR
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