Provider Demographics
NPI:1306205562
Name:SNOW, RONALD (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SNOW
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PEACHTREE ST NE APT 1310
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-6027
Mailing Address - Country:US
Mailing Address - Phone:205-362-1877
Mailing Address - Fax:
Practice Address - Street 1:800 PEACHTREE ST NE APT 1310
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-6027
Practice Address - Country:US
Practice Address - Phone:205-362-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001916171W00000X
ALMASSAGE 1666171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor