Provider Demographics
NPI:1871162768
Name:SHIRES, ELAINE SHELBY (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:SHELBY
Last Name:SHIRES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:SHELBY
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20317 183RD ST
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-5359
Mailing Address - Country:US
Mailing Address - Phone:913-901-7867
Mailing Address - Fax:
Practice Address - Street 1:11940 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2216
Practice Address - Country:US
Practice Address - Phone:913-563-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist