Provider Demographics
NPI:1265586515
Name:SNYDER, SUSAN TINKELENBERG (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:TINKELENBERG
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2974 NINTH TEE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-8575
Mailing Address - Country:US
Mailing Address - Phone:828-465-2651
Mailing Address - Fax:
Practice Address - Street 1:2372 EAGLE DR NE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9497
Practice Address - Country:US
Practice Address - Phone:828-459-9000
Practice Address - Fax:828-459-7610
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3806171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor