Healthcare Provider Details

I. General information

NPI: 1376344663
Provider Name (Legal Business Name): MAKAYLA SNIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 FALL HILL AVE
FREDERICKSBURG VA
22401-3000
US

IV. Provider business mailing address

5826 NEW BERNE RD
FREDERICKSBURG VA
22407-9438
US

V. Phone/Fax

Practice location:
  • Phone: 540-429-3346
  • Fax:
Mailing address:
  • Phone: 540-847-1623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: