Provider Demographics
NPI:1376672675
Name:SNYDER, WILLIAM RANDY (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RANDY
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 1:3460 MARRON RD # 103-364
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4675
Mailing Address - Country:US
Mailing Address - Phone:760-650-5288
Mailing Address - Fax:760-434-1443
Practice Address - Street 1:3460 MARRON RD # 103-364
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4675
Practice Address - Country:US
Practice Address - Phone:760-650-5288
Practice Address - Fax:760-434-1443
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor