Provider Demographics
NPI:1265712285
Name:SNYDER, CHRISTINE ANNE (MSOM, LAC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33298
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-0298
Mailing Address - Country:US
Mailing Address - Phone:505-850-8202
Mailing Address - Fax:
Practice Address - Street 1:630 15TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2700
Practice Address - Country:US
Practice Address - Phone:303-651-2525
Practice Address - Fax:303-651-2556
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1705171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist