Provider Demographics
NPI:1619193687
Name:SNYDER, DAVID LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:SNYDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MI
Mailing Address - Zip Code:48742-0237
Mailing Address - Country:US
Mailing Address - Phone:989-736-8138
Mailing Address - Fax:989-736-0618
Practice Address - Street 1:301 SECOND ST.
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MI
Practice Address - Zip Code:48742
Practice Address - Country:US
Practice Address - Phone:989-736-8138
Practice Address - Fax:989-736-0618
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist