Provider Demographics
NPI:1326792243
Name:SHAMBAUGH, MELANIE (DPT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:SHAMBAUGH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 VALLEY RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SHERMANS DALE
Mailing Address - State:PA
Mailing Address - Zip Code:17090-9549
Mailing Address - Country:US
Mailing Address - Phone:717-275-4119
Mailing Address - Fax:
Practice Address - Street 1:1104 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-6203
Practice Address - Country:US
Practice Address - Phone:717-210-5676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist