Basic Information
| Provider Information | |||||||||
| NPI: | 1396041414 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNOWE | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | PAIGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5971 E LINDEN PL | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857124320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205914521 | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 N WILMOT RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857112602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208733000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2011 | ||||||||
| LastUpdateDate: | 02/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5965 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.