Provider Demographics
NPI:1609074251
Name:SNYDER, JOHN CALVIN JR (MA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CALVIN
Last Name:SNYDER
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BLOUNTVILLE HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-0213
Mailing Address - Country:US
Mailing Address - Phone:423-764-4327
Mailing Address - Fax:423-764-2856
Practice Address - Street 1:350 BLOUNTVILLE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-0213
Practice Address - Country:US
Practice Address - Phone:423-764-4327
Practice Address - Fax:423-764-2856
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN098231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBCBS OF TNOtherBCBS OF TENNESSEE
TNBCBS OF TNOtherBCBS OF TENNESSEE