Provider Demographics
NPI:1538398805
Name:SNYDER, TRAVIS DAVID (ATC)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:DAVID
Last Name:SNYDER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 SILVER ARROWS WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-7411
Mailing Address - Country:US
Mailing Address - Phone:812-454-3664
Mailing Address - Fax:
Practice Address - Street 1:6109 SILVER ARROWS WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-7411
Practice Address - Country:US
Practice Address - Phone:812-454-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0026842255A2300X
MDA4433225200000X
MDA00007952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer