MEDICARE: MR. SCOTT THOMAS SNOW PT, DPT

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	225100000X	Physical Therapist	2004	NV

General Provider Information

NPI Number	:	1902841729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT THOMAS SNOW PT, DPT

Provider Business Mailing Address
First Line	:	1710 W HORIZON RIDGE PKWY STE 110
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-4901
Country	:	US
Telephone Number	:	702-489-9217
Fax Number	:	702-489-9134

Provider Business Practice Location Address
First Line	:	2870 BICENTENNIAL PKWY
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-4480
Country	:	US
Telephone Number	:	702-483-3669
Fax Number	:	702-483-3604

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	10/24/2022

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