Provider Demographics
NPI:1770820888
Name:SNYDER, ANDREW J (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
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 1:10200 CITY WALK DR UNIT 159
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-6912
Mailing Address - Country:US
Mailing Address - Phone:651-238-1401
Mailing Address - Fax:
Practice Address - Street 1:10075 CITY WALK DR STE C
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-9248
Practice Address - Country:US
Practice Address - Phone:651-238-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5752111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor