Individual
LORI J SNOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 562-2525
Mailing address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 562-2525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02941
IA
207Q00000X
Family Medicine Physician
Primary
101096
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1126946
—
IA
05
—
1669477972
—
MO
05
—
200586110A
—
KS
01
—
P00647173
RR MEDICARE
MO
Enumeration date
06/15/2005
Last updated
10/04/2016
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