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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SHANE NISSEN

Active Sole Proprietor

DR. SHANE NISSEN is a Physical Therapy Assistant healthcare provider located in CARROLL, Iowa. NPI 1629316369 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · CARROLL, IA

Registration Details

NPI Number
1629316369
Provider Type
Individual
Gender
Male
NPI Issued
Jan 30, 2013 (13.511945982512 yrs)
Last Updated
Jan 30, 2013
Licenses
9706 (AZ)
004889 (IA)
Sole Proprietor
Yes

Practice Information

Address
629 GRANADA RD
CARROLL, IA, 514011709
Browse IA providers · Browse ZIP 51401
Phone
7122102147
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in CARROLL, IA

Name Credential NPI
JENNIFER A. HANDLOS PT 1548209349
DR. EMMALIE ROSE RASMUSSEN D.P.T 1144429515
ANN MARIE RIAT PT 1659567642
DR. CHRISTOPHER BRYAN STAUB DPT, OCS, CGFI, MBA 1972895621
LUANN WALSH 1184974636
AMANDA K EISCHEID PT 1891127213
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.