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NPI Code Detail

MEDICARE: DAVID JOSEPH SNOVER PA-C, ATC

MEDICARE: DAVID JOSEPH SNOVER PA-C, 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 Trainer
2363AM0700XMedical Physician Assistant0110002352VA
3363AS0400XSurgical Physician AssistantPA.0003384CO
4363A00000XPhysician AssistantPA.0003384CO

General Provider Information

NPI Number : 1982653770
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JOSEPH SNOVER PA-C, ATC
Provider Business Mailing Address
First Line : PO BOX 130
Second Line :
City : FRUITA
State : CO
Zip : 81521-0130
Country : US
Telephone Number : 970-858-2186
Fax Number : 970-858-2208
Provider Business Practice Location Address
First Line : 300 W OTTLEY AVE
Second Line :
City : FRUITA
State : CO
Zip : 81521-2118
Country : US
Telephone Number : 970-858-2705
Fax Number : 970-858-9961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 09/11/2023

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