Provider Demographics
NPI:1457435232
Name:SNYDER, JOSEPH C JR (DPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:SNYDER
Suffix:JR
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1237
Mailing Address - Country:US
Mailing Address - Phone:423-743-4881
Mailing Address - Fax:423-743-0947
Practice Address - Street 1:101 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1237
Practice Address - Country:US
Practice Address - Phone:423-743-4881
Practice Address - Fax:423-743-0947
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist