Provider Demographics
NPI:1497241046
Name:SNYDER, LISA JOAN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JOAN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4942 80TH AVENUE PLZ E
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-4301
Mailing Address - Country:US
Mailing Address - Phone:941-284-7477
Mailing Address - Fax:
Practice Address - Street 1:5201 DESOTO RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-3607
Practice Address - Country:US
Practice Address - Phone:941-256-2609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA2137225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant