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Individual

RONALD LEE SNYDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
17615 STATE RD 23, SOUTH BEND, IN 46635
(574) 234-7600
(574) 234-8408
Mailing address
17615 STATE RD 23, SOUTH BEND, IN 46635
(574) 234-7600
(574) 234-8408

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001393
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000092862
ANTHEM
IN
05
200411330
IN
Enumeration date
03/09/2006
Last updated
12/13/2012
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