Provider Demographics
NPI:1144399486
Name:SNYDER, PATRICK A (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:SNYDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 DAMASCUS RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5535
Mailing Address - Country:US
Mailing Address - Phone:937-578-4019
Mailing Address - Fax:937-578-2542
Practice Address - Street 1:388 DAMASCUS RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-5535
Practice Address - Country:US
Practice Address - Phone:937-578-4019
Practice Address - Fax:937-578-2542
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH470959845027OtherCARESOURCE
OH10799627OtherCAQH
OHP00387805OtherRAILROAD MEDICARE
OH9490668OtherCIGNA
000000376607OtherBLUE CROSS/BLUE SHIELD
OH600162OtherUNITED HEALTHCARE
OH0460737Medicaid
OH1031185OtherAMERICAN SPECIALTY NETWOR
OH5433534OtherAETNA
OH10799627OtherCAQH
OH0826934Medicare PIN