Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ACA.200009 | LA |
NPI | 1225544323 |
---|---|
Provider Name | Donald J Snow JR. |
First Address | Lake Charles, LA 70601-5726 |
Second Address | Lake Charles, LA 70601-5726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2017 |
Last Update Date | 21/07/2021 |