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Contact Information

SHANE M BJORNBERG, PT
11049 N 147TH EAST AVE
OWASSO, OK74055-6263
 Phone: 918-978-6274
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for SHANE M BJORNBERG · (Male)

NPI # 1346302817
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 12/14/2006
Last updated 03/28/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • AR License # PT 3550
  • OK License # 3967
  • OK Medicaid 200034500A
  • OK Medicaid 200034500B
  • OK Medicaid 200034500C
  • OK Medicaid 200034500D
  • OK Medicaid 200034500E
  • OK Medicaid 200034500F
  • OK Medicaid 200034500G
  • OK Medicaid 200034500H
  • OK Medicaid 200034500I
  • OK Medicaid 200100580A
  • OK Other 7784889 AETNA
  • OK Other 6935423 CIGNA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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