MEDICARE: ISABELLA ANN SNOWDEN

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	225200000X	Physical Therapy Assistant	PTA013513	OH

General Provider Information

NPI Number	:	1750146890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABELLA ANN SNOWDEN

Provider Business Mailing Address
First Line	:	43756 FULDA RD
Second Line	:
City	:	CALDWELL
State	:	OH
Zip	:	43724-9587
Country	:	US
Telephone Number	:	702-290-8944
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 E MAIN ST
Second Line	:
City	:	MCCONNELSVILLE
State	:	OH
Zip	:	43756-1180
Country	:	US
Telephone Number	:	740-962-4441
Fax Number	:

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

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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