Provider Demographics
NPI:1598442469
Name:SNELL, COURTNEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SNELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 BUCKINGHAM GATE BLVD UNIT E
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-5513
Mailing Address - Country:US
Mailing Address - Phone:937-564-9564
Mailing Address - Fax:
Practice Address - Street 1:1460 BUCKINGHAM GATE BLVD UNIT E
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-5513
Practice Address - Country:US
Practice Address - Phone:937-564-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385HR2060X
OHPT021309225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child