Organization
LISLE SNYDER, DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISLE SNYDER (OWNER)
(423) 543-8719
Entity
Organization
Contact information
Practice address
207 W G ST, ELIZABETHTON, TN 37643-3113
(423) 543-8719
Mailing address
PO BOX 812, ELIZABETHTON, TN 37644-0812
(423) 543-8719
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006277
BCBS
TN
01
—
TN0101
MEDICARE COMPLETE
TN
Enumeration date
02/22/2008
Last updated
03/05/2008
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