Healthcare Provider Details

I. General information

NPI: 1952886756
Provider Name (Legal Business Name): JOY SNYDER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 MISSION RD
LEAWOOD KS
66224-9718
US

IV. Provider business mailing address

10700 NALL AVE
OVERLAND PARK KS
66211-1206
US

V. Phone/Fax

Practice location:
  • Phone: 316-461-5109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number24-01288
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: