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NPI Code Detail

MEDICARE: TRAVIS DAVID SNYDER ATC

MEDICARE:   TRAVIS DAVID SNYDER  ATC
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
12255A2300XAthletic TrainerAT.002684OH
2225200000XPhysical Therapy AssistantA4433MD
32255A2300XAthletic TrainerA0000795MD

General Provider Information

NPI Number : 1538398805
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRAVIS DAVID SNYDER ATC
Provider Business Mailing Address
First Line : 6109 SILVER ARROWS WAY
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-7411
Country : US
Telephone Number : 812-454-3664
Fax Number :
Provider Business Practice Location Address
First Line : 6109 SILVER ARROWS WAY
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-7411
Country : US
Telephone Number : 812-454-3664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 08/23/2016

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Directions to “ TRAVIS DAVID SNYDER ATC” Practice Location

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