| Doctor Name: | DR. IRA LAWRENCE SNIDER |
| NPI Number: | 1992039093 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | L1417691 |
| Business Practice Address: | 4222 N 12th St Ste 102 Phoenix, AZ - 850146023 |
| Business Phone Number: | 6022654357 |
| Business Fax Number: | 6026049352 |
| Mailing Address: | 4222 N 12th St Ste 102, PHOENIX |
| State: | AZ |
| Postal Code: | 850146023 |
| Phone Number: | 6022654357 |
| Fax Number: | 6026049352 |
| NPI Enumeration Date: | 09/23/2009 |
| NPI Last Update Date: | 10/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | L1417691 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |