Individual
PAUL SHANENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
11 N MAIN ST, GWINNER, ND 58040-4001
(701) 678-2244
(701) 678-2210
Mailing address
11 N MAIN ST, GWINNER, ND 58040-4001
(701) 678-2244
(701) 678-2210
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1778
ND
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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