Provider Demographics
NPI:1902635550
Name:A & M SNOW, INC.
Entity type:Organization
Organization Name:A & M SNOW, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:GOULEY
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:541-727-3376
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0400
Mailing Address - Country:US
Mailing Address - Phone:541-727-3376
Mailing Address - Fax:800-514-0191
Practice Address - Street 1:360 SW BOND ST STE 310
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3556
Practice Address - Country:US
Practice Address - Phone:541-727-3376
Practice Address - Fax:800-514-0191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SNOW DERMATOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-31
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty