Provider Demographics
NPI:1871277822
Name:SNIDER, DONALD
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:SNIDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 E OLD A AND P HWY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-9765
Mailing Address - Country:US
Mailing Address - Phone:193-751-5790
Mailing Address - Fax:
Practice Address - Street 1:4000 E OLD A AND P HWY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-9765
Practice Address - Country:US
Practice Address - Phone:193-751-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide