MEDICARE: DR. BASIL BENJAMIN SNYMAN 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	DC001542L	PA

General Provider Information

NPI Number	:	1609879568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASIL BENJAMIN SNYMAN D.C.

Provider Business Mailing Address
First Line	:	1608 WALNUT ST
Second Line	:	STE 601
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5457
Country	:	US
Telephone Number	:	215-546-1010
Fax Number	:	215-546-1005

Provider Business Practice Location Address
First Line	:	1608 WALNUT ST
Second Line	:	STE 601
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5457
Country	:	US
Telephone Number	:	215-546-1010
Fax Number	:	215-546-1005

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/01/2013

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