Provider Demographics
NPI:1548464878
Name:SNEARLY, KENDRA A (PT)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:A
Last Name:SNEARLY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5483
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:3715 SOUTHERN BLVD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-462-6050
Practice Address - Fax:505-467-6055
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2012-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist