Provider Demographics
NPI:1700603834
Name:SNYDER, LAVAR JOHN (OTR/L)
Entity type:Individual
Prefix:
First Name:LAVAR
Middle Name:JOHN
Last Name:SNYDER
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 COUNTRY CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-5830
Mailing Address - Country:US
Mailing Address - Phone:775-777-1276
Mailing Address - Fax:775-777-7022
Practice Address - Street 1:2072 IDAHO ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2627
Practice Address - Country:US
Practice Address - Phone:775-777-1276
Practice Address - Fax:775-777-7022
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-3110225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist