Provider Demographics
NPI:1316271497
Name:SNYDER, KELLI R (ATC)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:R
Last Name:SNYDER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3G HPC
Mailing Address - Street 2:UNIVERSITY OF NORTHERN IOWA
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50614-0001
Mailing Address - Country:US
Mailing Address - Phone:319-273-7401
Mailing Address - Fax:319-273-7023
Practice Address - Street 1:3G HUMAN PERFORMANCE CTR
Practice Address - Street 2:UNIVERSITY OF NORTHERN IOWA
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50614-0001
Practice Address - Country:US
Practice Address - Phone:319-273-7401
Practice Address - Fax:319-273-7023
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer