Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Champion

Individual provider Physical Therapy Assistant · NPI 1497033187

Shane Champion is a Physical Therapy Assistant in Grand Bay, Alabama. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2011

Practice location Address checks out

5500 Dara Ln
Grand Bay, AL 36541-3465
Phone: (251) 454-1897
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA3404 (MS)

Record details

NPI number1497033187
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 28, 2011
Last updated in NPPESJuly 28, 2011
Mailing address5500 Dara Ln, Grand Bay, AL 36541-3465