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General NPI Number Information
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NPI Number | 1780953182
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Entity Type | Individual
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Provider Name | CRAIG LEE SNIDER DPT
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Gender | Male
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1044 SAGAMORE PKWY W UNIT A
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1446
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Country | US
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Telephone | 765-250-4445
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-1925
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Country | US
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Telephone | 620-575-1980
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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 | TN-PT0000009151
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT017255
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05015756A
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License Number State | IN
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