Provider Demographics
NPI:1922194588
Name:SNELL, REBECCA LYN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYN
Last Name:SNELL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 KELLER HICKS ROAD
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-9622
Mailing Address - Country:US
Mailing Address - Phone:817-688-7345
Mailing Address - Fax:817-337-5619
Practice Address - Street 1:4255 AMON CARTER BLVD.
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76155
Practice Address - Country:US
Practice Address - Phone:817-963-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1114197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist