Healthcare Provider Details

I. General information

NPI: 1851969240
Provider Name (Legal Business Name): LEAH SNYDER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E CHEYENNE MOUNTAIN BLVD STE N
COLORADO SPRINGS CO
80906-3769
US

IV. Provider business mailing address

612 JEMISON GRV APT 305
COLORADO SPRINGS CO
80915-3684
US

V. Phone/Fax

Practice location:
  • Phone: 719-527-9331
  • Fax: 719-527-9372
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0017582
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: