Provider Demographics
NPI:1952620130
Name:SNYDER, ALYSSA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:MARIE
Last Name:SNYDER
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 1:1305 E COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2011
Mailing Address - Country:US
Mailing Address - Phone:507-337-4007
Mailing Address - Fax:507-540-0053
Practice Address - Street 1:1305 E COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2011
Practice Address - Country:US
Practice Address - Phone:507-337-4007
Practice Address - Fax:844-893-8311
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3204152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist