Provider Demographics
NPI:1447622840
Name:SNIDER, AMANDA (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SNIDER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N MAIN ST APT 201
Mailing Address - Street 2:
Mailing Address - City:MERCERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17236-1760
Mailing Address - Country:US
Mailing Address - Phone:717-328-2121
Mailing Address - Fax:717-328-2127
Practice Address - Street 1:123 N MAIN ST APT 201
Practice Address - Street 2:
Practice Address - City:MERCERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17236-1760
Practice Address - Country:US
Practice Address - Phone:717-328-2121
Practice Address - Fax:717-328-2127
Is Sole Proprietor?:No
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist