Provider Demographics
NPI:1902841729
Name:SNOW, SCOTT THOMAS (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:THOMAS
Last Name:SNOW
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 W HORIZON RIDGE PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4901
Mailing Address - Country:US
Mailing Address - Phone:702-489-9217
Mailing Address - Fax:702-489-9134
Practice Address - Street 1:2870 BICENTENNIAL PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-4480
Practice Address - Country:US
Practice Address - Phone:702-483-3669
Practice Address - Fax:702-483-3604
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV102143Medicare ID - Type Unspecified