Healthcare Provider Details

I. General information

NPI: 1881103307
Provider Name (Legal Business Name): ROB SNYDER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2017
Last Update Date: 09/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PENNY LN
WATSONVILLE CA
95076-3079
US

IV. Provider business mailing address

316 MID VALLEY CTR # 110
CARMEL CA
93923-8516
US

V. Phone/Fax

Practice location:
  • Phone: 831-238-6700
  • Fax:
Mailing address:
  • Phone: 831-238-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT12073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: