Provider Demographics
NPI:1588848832
Name:SNYDER, GLENN MERVIN (DC)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:MERVIN
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 1:122 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1603
Mailing Address - Country:US
Mailing Address - Phone:215-257-0104
Mailing Address - Fax:
Practice Address - Street 1:122 S 2ND ST
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-1603
Practice Address - Country:US
Practice Address - Phone:215-257-0104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001402L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor