Provider Demographics
NPI:1043222037
Name:SNIEZEK, CAROLYN JOAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JOAN
Last Name:SNIEZEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CENTURY WAY
Mailing Address - Street 2:
Mailing Address - City:DUNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:01827-1201
Mailing Address - Country:US
Mailing Address - Phone:978-649-2134
Mailing Address - Fax:
Practice Address - Street 1:493 MAIN ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-4254
Practice Address - Country:US
Practice Address - Phone:978-449-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist