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General NPI Number Information
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NPI Number | 1639336415
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Entity Type | Organization
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Legal Business Name | SNYDER CHIROPRACTIC P.L.L.C.
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 4146 S HARVARD AVE STE F-5
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City | TULSA
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State | OK
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Zip | 74135-2610
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Country | US
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Telephone | 918-749-7772
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Fax | 918-749-9772
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Provider Business Mailing Address
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Address Line | 4146 S HARVARD AVE STE F-5
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City | TULSA
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State | OK
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Zip | 74135-2610
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Country | US
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Telephone | 918-749-7772
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Fax | 918-749-9772
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN G SNYDER
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Credential | D.C.
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Telephone | 918-749-7772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3838
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License Number State | OK
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