Individual
MR. SHANNON DALE SNIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P. T., CSCS
Contact information
Practice address
309 LA GRANGE RD, PEWEE VALLEY, KY 40056-9168
(502) 243-6868
(502) 243-6867
Mailing address
PO BOX 615, 309 LAGRANGE RD., PEWEE VALLEY, KY 40056-0615
(502) 243-6868
(502) 243-6867
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003490
KY
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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