Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC11342 | CA |
N | 111NI0013X | Independent Medical Examiner | DC11342 | CA |
Y | 111NS0005X | Chiropractic Sports Physician | DC11342 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC11342 | CA |
NPI | 1730504978 |
---|---|
Provider Name | Roxann Dee Snyder |
First Address | West Covina, CA 91792-1527 |
Second Address | West Covina, CA 91792-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2014 |
Last Update Date | 25/02/2014 |