Provider Demographics
NPI:1467429290
Name:FORT LOWELL PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:FORT LOWELL PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:520-323-9086
Mailing Address - Street 1:2560 E FORT LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1514
Mailing Address - Country:US
Mailing Address - Phone:520-323-9086
Mailing Address - Fax:520-323-6364
Practice Address - Street 1:2560 E FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1514
Practice Address - Country:US
Practice Address - Phone:520-323-9086
Practice Address - Fax:520-323-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ05542251X0800X
AZ10262251X0800X
AZ10692251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty