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Individual

DR. IRA LAWRENCE SNIDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4222 N 12TH ST STE 102, PHOENIX, AZ 85014-6023
(602) 265-4357
(602) 604-9352
Mailing address
1343 N ALMA SCHOOL RD, STE 160, CHANDLER, AZ 85224-5901
(480) 963-1853
(480) 963-1854

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4745
AZ
208D00000X
General Practice Physician
L1417691
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
711680
AZ
Enumeration date
09/23/2009
Last updated
03/22/2019
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