Basic Information
| Provider Information | |||||||||
| NPI: | 1376112755 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNYDER | ||||||||
| FirstName: | RACHEL | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | W346S9015 WHITETAIL DR | ||||||||
| Address2: | |||||||||
| City: | EAGLE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531192300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2625279117 | ||||||||
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| Practice Location | |||||||||
| Address1: | HWYS. 50 AND 67, N2950 STATE RD. 67 | ||||||||
| Address2: | |||||||||
| City: | LAKE GENEVA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622454980 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2021 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 15442-24 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.