MEDICARE: DR. NIMARA LYNN SNYDER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4674	NC
2	111N00000X	Chiropractor	008259	GA

General Provider Information

NPI Number	:	1083153373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIMARA LYNN SNYDER D.C.

Provider Business Mailing Address
First Line	:	29 MADISON ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-6725
Country	:	US
Telephone Number	:	404-822-1955
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 SHIPYARD BLVD
Second Line	:	SUITE 108
City	:	WILMINGTON
State	:	NC
Zip	:	28412-6562
Country	:	US
Telephone Number	:	404-822-1955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2017
Last Update Date	:	02/20/2017

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