MEDICARE: SNYDER CHIROPRACTIC HEALTH CENTER

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	DC12545	CA

General Provider Information

NPI Number	:	1780999227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNYDER CHIROPRACTIC HEALTH CENTER

Provider Business Mailing Address
First Line	:	11340 W OLYMPIC BLVD STE 138
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1611
Country	:	US
Telephone Number	:	310-473-4400
Fax Number	:	310-473-7752

Provider Business Practice Location Address
First Line	:	11340 W OLYMPIC BLVD STE 138
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1611
Country	:	US
Telephone Number	:	310-473-4400
Fax Number	:	310-473-7752

Authorized Official
Title or Position	:	OWENER
Name	:	DR. NEAL GARY SNYDER
Credential	:	D.C.
Telephone Number	:	310-473-4400

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	08/09/2010

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