Healthcare Provider Details
I. General information
NPI: 1962253203
Provider Name (Legal Business Name): SNAPSHOT HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
907 S DETROIT AVE STE 100
TULSA OK
74120-4253
US
IV. Provider business mailing address
907 S DETROIT AVE STE 100
TULSA OK
74120-4253
US
V. Phone/Fax
- Phone: 323-708-0382
- Fax:
- Phone: 323-708-0382
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
KURTZ
Title or Position: CEO
Credential:
Phone: 323-708-0382