Provider Demographics
NPI:1942484076
Name:GIEBNER, SHAWN (PT, ATC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:GIEBNER
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 LAC DEVILLE BLVD.
Mailing Address - Street 2:BUILDING D SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-341-9150
Mailing Address - Fax:585-340-9745
Practice Address - Street 1:4901 LAC DEVILLE BLVD.
Practice Address - Street 2:BUILDING D SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-341-9150
Practice Address - Fax:585-340-9745
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62 0274912251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports