Provider Demographics
NPI:1972620714
Name:SNELL, AMY ALLISON (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ALLISON
Last Name:SNELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 HORSESHOE DR APT 3214
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-2024
Mailing Address - Country:US
Mailing Address - Phone:337-281-6148
Mailing Address - Fax:
Practice Address - Street 1:3805 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3563
Practice Address - Country:US
Practice Address - Phone:318-442-9332
Practice Address - Fax:318-442-9344
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1250-398T152W00000X
KS2093152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist