Healthcare Provider Details

I. General information

NPI: 1427887868
Provider Name (Legal Business Name): GRIFFIN RILLEY SNYDER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 MERCHANTS WALK
SUMMERSVILLE WV
26651-1901
US

IV. Provider business mailing address

PO BOX 69
SUMMERSVILLE WV
26651-0069
US

V. Phone/Fax

Practice location:
  • Phone: 304-872-7498
  • Fax: 304-872-8144
Mailing address:
  • Phone: 304-872-7498
  • Fax: 304-872-8144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT004795
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: