Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA 26747 | FL |
NPI | 1003364951 |
---|---|
Provider Name | Laura Michelle Snyder |
First Address | Seminole, FL 33777-4140 |
Second Address | Seminole, FL 33777-4140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2016 |
Last Update Date | 20/09/2016 |