Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 13665 | TN |
NPI | 1033887377 |
---|---|
Provider Name | Mrs. Cydney Shea Bunn |
First Address | Kingsport, TN 37663-2640 |
Second Address | Gray, TN 37615-2245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2021 |
Last Update Date | 01/09/2021 |