Healthcare Provider Details

I. General information

NPI: 1588207302
Provider Name (Legal Business Name): DONNA JO SNYDER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CAPE MAY DR
WILMINGTON OH
45177-2065
US

IV. Provider business mailing address

3728 E US HIGHWAY 22 3
WILMINGTON OH
45177-9304
US

V. Phone/Fax

Practice location:
  • Phone: 937-382-0902
  • Fax:
Mailing address:
  • Phone: 937-725-9092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9007
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: