Provider Demographics
NPI:1124366810
Name:SNYDER, ERIN (LMT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7238
Mailing Address - Country:US
Mailing Address - Phone:701-732-7570
Mailing Address - Fax:
Practice Address - Street 1:4401 S 11TH ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7238
Practice Address - Country:US
Practice Address - Phone:701-732-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1050174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist