MEDICARE: MS. REBECCA LYN SNELL PHYSICAL THERAPIST

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	1114197	TX

General Provider Information

NPI Number	:	1922194588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA LYN SNELL PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	3918 KELLER HICKS ROAD
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-9622
Country	:	US
Telephone Number	:	817-688-7345
Fax Number	:	817-337-5619

Provider Business Practice Location Address
First Line	:	4255 AMON CARTER BLVD.
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155
Country	:	US
Telephone Number	:	817-963-1200
Fax Number	:

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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