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NPI Code Detail

MEDICARE: BRIDGETTE RENEE BUNKER DPT

MEDICARE: BRIDGETTE RENEE BUNKER 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
1225100000XPhysical Therapist9985NC
2225100000XPhysical Therapist9435SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932141371
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGETTE RENEE BUNKER DPT
Provider Business Mailing Address
First Line : PO BOX 530062
Second Line :
City : ATLANTA
State : GA
Zip : 30353-0062
Country : US
Telephone Number : 843-695-6071
Fax Number : 843-569-5879
Provider Business Practice Location Address
First Line : 7611 SAINT ANDREWS RD
Second Line :
City : IRMO
State : SC
Zip : 29063-2834
Country : US
Telephone Number : 803-714-3300
Fax Number : 803-626-9356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 06/15/2021

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Directions to “ BRIDGETTE RENEE BUNKER DPT” Practice Location

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