MEDICARE: MRS. KIRSTEN SOLBERG SNAPE MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	5235	SC

General Provider Information

NPI Number	:	1619042694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIRSTEN SOLBERG SNAPE MPT

Provider Business Mailing Address
First Line	:	578 OLD SIX MILE RD
Second Line	:
City	:	CENTRAL
State	:	SC
Zip	:	29630-3305
Country	:	US
Telephone Number	:	864-985-3647
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 FOREST LN
Second Line	:	SUITE A
City	:	CLEMSON
State	:	SC
Zip	:	29631-2621
Country	:	US
Telephone Number	:	864-654-2001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	10/20/2011

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