Provider Demographics
NPI:1205449618
Name:SNIGAR, KOURTNEY JANE
Entity type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:JANE
Last Name:SNIGAR
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 1:269 ARROWHEAD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BRACKNEY
Mailing Address - State:PA
Mailing Address - Zip Code:18812-7712
Mailing Address - Country:US
Mailing Address - Phone:570-663-2687
Mailing Address - Fax:
Practice Address - Street 1:4201 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-5409
Practice Address - Country:US
Practice Address - Phone:215-951-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer