Provider Demographics
NPI:1659506616
Name:SNYDER, JODY
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 POINSETT HWY
Mailing Address - Street 2:APT. 14
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-2223
Mailing Address - Country:US
Mailing Address - Phone:864-233-5960
Mailing Address - Fax:
Practice Address - Street 1:2627 POINSETT HWY
Practice Address - Street 2:APT. 14
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-2223
Practice Address - Country:US
Practice Address - Phone:864-233-5960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1210225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant