Provider Demographics
NPI:1952488496
Name:SNYDER, ROGER B (DC)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:B
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 1:1084 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-4743
Mailing Address - Country:US
Mailing Address - Phone:419-352-9293
Mailing Address - Fax:419-352-2380
Practice Address - Street 1:1084 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-4743
Practice Address - Country:US
Practice Address - Phone:419-352-9293
Practice Address - Fax:419-352-2380
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSN0443264Medicare ID - Type Unspecified