Provider Demographics
NPI:1689836256
Name:ROGER B. SNYDER, D.C., INC.
Entity Type:Organization
Organization Name:ROGER B. SNYDER, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-352-9293
Mailing Address - Street 1:536 PEARL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2780
Mailing Address - Country:US
Mailing Address - Phone:419-352-9293
Mailing Address - Fax:419-352-2380
Practice Address - Street 1:536 PEARL ST
Practice Address - Street 2:SUITE B
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2780
Practice Address - Country:US
Practice Address - Phone:419-352-9293
Practice Address - Fax:419-352-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH699261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service