Healthcare Provider Details

I. General information

NPI: 1497780258
Provider Name (Legal Business Name): CRAIG SNYDER P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 ROY ST
ORTONVILLE MN
56278-1138
US

IV. Provider business mailing address

203 S PARK STREET
NORTHWOOD ND
58267
US

V. Phone/Fax

Practice location:
  • Phone: 320-839-4090
  • Fax: 320-839-4089
Mailing address:
  • Phone: 320-305-0233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7308
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1248
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1486
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: