Healthcare Provider Details

I. General information

NPI: 1083941280
Provider Name (Legal Business Name): SHANNON L NEUMANN LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11357 DORAN RD
WHITEHOUSE OH
43571-9711
US

IV. Provider business mailing address

11357 DORAN RD
WHITEHOUSE OH
43571-9711
US

V. Phone/Fax

Practice location:
  • Phone: 419-877-9292
  • Fax:
Mailing address:
  • Phone: 419-877-9292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP022490T
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP037141T
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-009741
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: