Healthcare Provider Details

I. General information

NPI: 1780376152
Provider Name (Legal Business Name): SAMANTHA SNYDER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 WESTMINSTER BLVD UNIT 120
WESTMINSTER CO
80020-4182
US

IV. Provider business mailing address

10883 W 84TH PL
ARVADA CO
80005-5244
US

V. Phone/Fax

Practice location:
  • Phone: 303-593-0696
  • Fax:
Mailing address:
  • Phone: 303-906-4736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019108
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: