Healthcare Provider Details

I. General information

NPI: 1609438811
Provider Name (Legal Business Name): ALLIE R SNYDER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLIE R SCHULTE

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7686 WALNUT ST
OMAHA NE
68124-1717
US

IV. Provider business mailing address

2336 N 60TH AVE
OMAHA NE
68104-4010
US

V. Phone/Fax

Practice location:
  • Phone: 402-819-8477
  • Fax:
Mailing address:
  • Phone: 402-657-0955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3961
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: