Healthcare Provider Details

I. General information

NPI: 1538189758
Provider Name (Legal Business Name): JANELLE LYNN SNYDER LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 S CENTER ST
MARSHALLTOWN IA
50158-5945
US

IV. Provider business mailing address

1218 LARKFIELD CT
MARSHALLTOWN IA
50158-4647
US

V. Phone/Fax

Practice location:
  • Phone: 641-754-6120
  • Fax:
Mailing address:
  • Phone: 641-752-5847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number00015
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number00658
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: