Provider Demographics
NPI:1619142676
Name:SNELL, KRISTINE M (PTA)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:M
Last Name:SNELL
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 1:287 HIDDEN LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-4243
Mailing Address - Country:US
Mailing Address - Phone:828-200-9421
Mailing Address - Fax:
Practice Address - Street 1:3195 OLD MURPHY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7213
Practice Address - Country:US
Practice Address - Phone:828-524-7806
Practice Address - Fax:828-349-4319
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3412225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant