Provider Demographics
NPI:1861776395
Name:STRASBURG, SHANE CHRISTOPHER (DPT)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:CHRISTOPHER
Last Name:STRASBURG
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 1:115 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030
Mailing Address - Country:US
Mailing Address - Phone:918-352-3838
Mailing Address - Fax:918-352-2844
Practice Address - Street 1:115 E BROADWAY
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030
Practice Address - Country:US
Practice Address - Phone:918-352-3838
Practice Address - Fax:918-352-2844
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT4473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist