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General NPI Number Information
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NPI Number | 1730398785
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Entity Type | Individual
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Provider Name | JUSTIN GREGG SNYDER D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 12/18/2009
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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 |
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Provider Business Mailing Address
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Address Line | 2418 S LOUISVILLE AVE
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City | TULSA
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State | OK
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Zip | 74114-3424
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Country | US
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Telephone | 918-749-7772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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