Provider Demographics
NPI:1649595661
Name:SNYDER, DAVID WALTER (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WALTER
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 1:5603 SR 14
Mailing Address - Street 2:
Mailing Address - City:REVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266
Mailing Address - Country:US
Mailing Address - Phone:330-296-9155
Mailing Address - Fax:
Practice Address - Street 1:5603 STATE ROUTE 14
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-8747
Practice Address - Country:US
Practice Address - Phone:330-296-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor