Healthcare Provider Details

I. General information

NPI: 1710476460
Provider Name (Legal Business Name): LAUREN ELIZABETH SNYDER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ELIZABETH MICHAEL PT, DPT

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E YOUNG AVE
WARRENSBURG MO
64093
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 660-262-4795
  • Fax: 660-747-0347
Mailing address:
  • Phone: 423-238-7212
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2018028498
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: