Healthcare Provider Details

I. General information

NPI: 1669871356
Provider Name (Legal Business Name): JOHN THOMAS SNYDER PT, DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 W 1ST AVE
COLUMBUS OH
43212-3302
US

IV. Provider business mailing address

1670 W 1ST AVE
COLUMBUS OH
43212-3302
US

V. Phone/Fax

Practice location:
  • Phone: 614-636-3555
  • Fax: 614-678-8444
Mailing address:
  • Phone: 614-636-3555
  • Fax: 614-678-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.015233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: