Provider Demographics
NPI:1235468646
Name:ELA-SNOWDON, VIRGINIA MAY (RPT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:MAY
Last Name:ELA-SNOWDON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HARRINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5236
Mailing Address - Country:US
Mailing Address - Phone:413-822-7941
Mailing Address - Fax:
Practice Address - Street 1:52 HARRINGTON AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-5236
Practice Address - Country:US
Practice Address - Phone:413-822-7941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAH2840PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist