Provider Demographics
NPI:1518359629
Name:HILLMAN, SHANE B
Entity Type:Individual
Prefix:
First Name:SHANE
Middle Name:B
Last Name:HILLMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 MASTIN ST # B
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5723
Mailing Address - Country:US
Mailing Address - Phone:913-681-0606
Mailing Address - Fax:
Practice Address - Street 1:15100 METCALF AVE STE 102
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2899
Practice Address - Country:US
Practice Address - Phone:913-681-7628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant