Individual
BOB SHINABARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
949 HARMON ST, STURGIS, SD 57785-2452
(605) 720-2400
Mailing address
PO BOX 3450, RAPID CITY, SD 57709-3450
(605) 720-2400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1212
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1212
SD LICENSE
SD
Enumeration date
07/18/2007
Last updated
07/18/2007
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