Provider Demographics
NPI:1649229659
Name:SNYDER, NICHOLAS JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JACOB
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 1:7202 GILES RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-6000
Mailing Address - Country:US
Mailing Address - Phone:402-932-6006
Mailing Address - Fax:402-504-6217
Practice Address - Street 1:7202 GILES RD
Practice Address - Street 2:SUITE 7
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-6000
Practice Address - Country:US
Practice Address - Phone:402-932-6006
Practice Address - Fax:402-504-6217
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1515111N00000X
IA06874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor