Mccomas, Shane Edward

Mccomas, Shane Edward is an individual health care provider with primary practice located at 200 Main Ave S , Park Rapids MN 56470-1518. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Mccomas, Shane Edward can be contacted via phone (218) 732-0868.

Contact Information

Primary practice address
200 Main Ave S Park Rapids MN 56470-1518
Phone: (218) 732-0868
Fax: (218) 732-8502
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X A1065 Minnesota

Profile Details

NPI number 1407297393
LBN Legal business name Mccomas, Shane Edward
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2013
Last updated Jul 9th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407297393 NPPES
Minnesota MEDICAID 683227000

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