Provider Demographics
NPI:1275043606
Name:SNYDER, DAWNA KAY (PT)
Entity Type:Individual
Prefix:
First Name:DAWNA
Middle Name:KAY
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:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:KS
Mailing Address - Zip Code:67880-0381
Mailing Address - Country:US
Mailing Address - Phone:620-353-4559
Mailing Address - Fax:
Practice Address - Street 1:854 N SOCORA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3288
Practice Address - Country:US
Practice Address - Phone:316-729-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4460225100000X
OK3961225100000X
KS11-01670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist