Provider Demographics
NPI:1427653690
Name:SNYDER, NICHOLAS GEORGE (DC, DIBCN)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:GEORGE
Last Name:SNYDER
Suffix:
Gender:M
Credentials:DC, DIBCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 HIDDEN PEARL PL
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-3182
Mailing Address - Country:US
Mailing Address - Phone:772-321-8122
Mailing Address - Fax:
Practice Address - Street 1:1575 INDIAN RIVER BLVD STE C210
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7127
Practice Address - Country:US
Practice Address - Phone:772-217-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13278111NN0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty