MEDICARE: MRS. DAWN TAMMY SNOW DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305204233	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	194507	OTHER	VA	ANTHEM
2	7208944	OTHER	VA	AETNA
3	10002763	OTHER	VA	OPTIMA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023048709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN TAMMY SNOW DPT

Provider Business Mailing Address
First Line	:	350 NEW FIDELITY CT
Second Line	:
City	:	GARNER
State	:	NC
Zip	:	27529-2665
Country	:	US
Telephone Number	:	919-373-2919
Fax Number	:	410-648-4878

Provider Business Practice Location Address
First Line	:	13048 RIVERS BEND RD
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2564
Country	:	US
Telephone Number	:	804-530-3330
Fax Number	:	804-530-9998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	09/15/2022

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