Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1066108 | TX |
NPI | 1003126798 |
---|---|
Provider Name | Mrs. Linda Carol Snow |
First Address | Waller, TX 77484-6188 |
Second Address | Navasota, TX 77868-3240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2010 |
Last Update Date | 14/10/2010 |