Provider Demographics
NPI:1316983059
Name:SNOW, ROBERT MASON (DPT, OCS, ATC CSCS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MASON
Last Name:SNOW
Suffix:
Gender:M
Credentials:DPT, OCS, ATC CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1726
Mailing Address - Country:US
Mailing Address - Phone:801-436-3110
Mailing Address - Fax:385-200-2246
Practice Address - Street 1:205 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1726
Practice Address - Country:US
Practice Address - Phone:801-436-3110
Practice Address - Fax:801-436-3110
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27544225100000X
UT10484958-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT27544Medicare ID - Type Unspecified
WPT27544BMedicare ID - Type Unspecified
WPT27544AMedicare ID - Type Unspecified
WPT27544CMedicare ID - Type Unspecified