MEDICARE: MARINA SHUNNARAH PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	PTH12550	AL

General Provider Information

NPI Number	:	1821952540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA SHUNNARAH PT, DPT

Provider Business Mailing Address
First Line	:	4209 DOLLY RIDGE RD
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5703
Country	:	US
Telephone Number	:	205-312-7925
Fax Number	:	205-990-2019

Provider Business Practice Location Address
First Line	:	4209 DOLLY RIDGE RD
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5703
Country	:	US
Telephone Number	:	205-312-7925
Fax Number	:	205-990-2019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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