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General NPI Number Information
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NPI Number | 1952620130
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Entity Type | Individual
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Provider Name | ALYSSA MARIE SNYDER O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 1305 E COLLEGE DR
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City | MARSHALL
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State | MN
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Zip | 56258-2011
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Country | US
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Telephone | 507-337-4007
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Fax | 844-893-8311
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Provider Business Mailing Address
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Address Line | 1305 E COLLEGE DR
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City | MARSHALL
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State | MN
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Zip | 56258-2011
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Country | US
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Telephone | 507-337-4007
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Fax | 507-540-0053
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3204
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License Number State | MN
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