Individual
ETHAN LEROY SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
585 N MOUNTAIN AVE STE A, UPLAND, CA 91786-8516
(909) 608-7546
Mailing address
101 E REDLANDS BLVD STE 284, REDLANDS, CA 92373-4721
(909) 312-7380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA63622
CA
Other
Enumeration date
06/06/2022
Last updated
01/06/2024
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