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General NPI Number Information
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NPI Number | 1508711607
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Entity Type | Individual
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Provider Name | ANTONIO BURRELL SNOW
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Gender | Male
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1406 PRUETER RD
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City | SAGINAW
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State | MI
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Zip | 48601-6616
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Country | US
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Telephone | 773-664-8780
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 PRUETER RD
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City | SAGINAW
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State | MI
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Zip | 48601-6616
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Country | US
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Telephone | 773-664-8780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | S500067081273
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License Number State | MI
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