Healthcare Provider Details

I. General information

NPI: 1902558414
Provider Name (Legal Business Name): TERRI L SNYDER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 SPRING VILLAGE DR
SPRINGFIELD VA
22150-4485
US

IV. Provider business mailing address

10155 MARSHALL POND RD
BURKE VA
22015-3729
US

V. Phone/Fax

Practice location:
  • Phone: 703-913-1200
  • Fax:
Mailing address:
  • Phone: 571-215-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305005092
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: