Provider Demographics
NPI:1194419309
Name:SHAMBURG, AARON (DPT)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:SHAMBURG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426A MCCALL RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5032
Mailing Address - Country:US
Mailing Address - Phone:785-776-0670
Mailing Address - Fax:785-776-0096
Practice Address - Street 1:426A MCCALL RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5032
Practice Address - Country:US
Practice Address - Phone:785-776-0670
Practice Address - Fax:785-776-0096
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist