Provider Demographics
NPI:1891440319
Name:SNINCHAK, SPENSER (ATC, PTA)
Entity Type:Individual
Prefix:
First Name:SPENSER
Middle Name:
Last Name:SNINCHAK
Suffix:
Gender:M
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-1208
Mailing Address - Country:US
Mailing Address - Phone:740-381-5283
Mailing Address - Fax:
Practice Address - Street 1:824 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1208
Practice Address - Country:US
Practice Address - Phone:740-381-5283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA013128225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant