Provider Demographics
NPI:1760883391
Name:VOLKMAN, SHANNON (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:VOLKMAN
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PALACE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-6264
Mailing Address - Country:US
Mailing Address - Phone:620-271-0700
Mailing Address - Fax:620-217-0703
Practice Address - Street 1:1800 PALACE DR
Practice Address - Street 2:SUITE C
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-6264
Practice Address - Country:US
Practice Address - Phone:620-271-0700
Practice Address - Fax:620-217-0703
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1246266225100000X
KS11-05520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist