Provider Demographics
NPI:1245972983
Name:SNOW, ANGELA M
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:SNOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-4619
Mailing Address - Country:US
Mailing Address - Phone:716-403-0121
Mailing Address - Fax:
Practice Address - Street 1:23 W 3RD ST APT 500
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-5118
Practice Address - Country:US
Practice Address - Phone:716-403-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath