Healthcare Provider Details

I. General information

NPI: 1427096940
Provider Name (Legal Business Name): DANIEL SNIDER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 E CLINTON AVE
FRESNO CA
93703-2223
US

IV. Provider business mailing address

1981 SERENA AVE
CLOVIS CA
93619-2845
US

V. Phone/Fax

Practice location:
  • Phone: 559-225-6100
  • Fax:
Mailing address:
  • Phone: 559-298-8967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT18988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: