Provider Demographics
NPI:1033298286
Name:SHANK, ROBERT HYATT (ATC, EMT-B)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HYATT
Last Name:SHANK
Suffix:
Gender:M
Credentials:ATC, EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KLINE CENTER
Mailing Address - Street 2:DICKINSON COLLEGE
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2896
Mailing Address - Country:US
Mailing Address - Phone:717-245-1366
Mailing Address - Fax:717-245-1441
Practice Address - Street 1:KLINE CENTER
Practice Address - Street 2:DICKINSON COLLEGE
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2896
Practice Address - Country:US
Practice Address - Phone:717-245-1366
Practice Address - Fax:717-245-1441
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000330A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer