Provider Demographics
NPI:1972962629
Name:SNOW, LEAH (LPTA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 BUSINESS PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090
Mailing Address - Country:US
Mailing Address - Phone:615-443-4445
Mailing Address - Fax:
Practice Address - Street 1:163 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-1241
Practice Address - Country:US
Practice Address - Phone:615-443-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA0000006088225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant