Healthcare Provider Details

I. General information

NPI: 1285006148
Provider Name (Legal Business Name): KAREN E SNYDER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2015
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 THAYER CT
AURORA IL
60504-6183
US

IV. Provider business mailing address

PO BOX 242007
MONTGOMERY AL
36124-2007
US

V. Phone/Fax

Practice location:
  • Phone: 630-870-4735
  • Fax: 630-984-2177
Mailing address:
  • Phone: 334-396-3273
  • Fax: 334-396-4905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.010425
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: