Provider Demographics
NPI:1083396360
Name:SNYDER, ADAM MICHAEL
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MICHAEL
Last Name:SNYDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5308 DARLINGTON RD APT D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-6214
Mailing Address - Country:US
Mailing Address - Phone:419-340-1927
Mailing Address - Fax:
Practice Address - Street 1:6100 N HAMILTON RD STE 1F
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2062
Practice Address - Country:US
Practice Address - Phone:614-293-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008858225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation