Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CHIR009565 | GA |
Y | 111N00000X | Chiropractor | CR2465 | ME |
N | 111NN1001X | Nutrition | CHIR009565 | GA |
NPI | 1639555097 |
---|---|
Provider Name | Dr. Alix Snyder |
First Address | Kennesaw, GA 30144-2888 |
Second Address | Yarmouth, ME 04096-6937 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2015 |
Last Update Date | 10/07/2018 |