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General NPI Number Information
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NPI Number | 1538474366
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Entity Type | Individual
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Provider Name | GRANT (BILL) CANNON SNARR PT
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Gender | Male
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 13413 GROVE DR
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City | ALPINE
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State | UT
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Zip | 84004-1838
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Country | US
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Telephone | 801-368-7976
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Fax |
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Provider Business Mailing Address
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Address Line | 13413 GROVE DR
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City | ALPINE
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State | UT
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Zip | 84004-1838
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Country | US
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Telephone | 801-368-7976
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 167735-2401
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License Number State | UT
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