Healthcare Provider Details

I. General information

NPI: 1821952540
Provider Name (Legal Business Name): MARINA SHUNNARAH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 DOLLY RIDGE RD
VESTAVIA AL
35243-5703
US

IV. Provider business mailing address

4209 DOLLY RIDGE RD
VESTAVIA AL
35243-5703
US

V. Phone/Fax

Practice location:
  • Phone: 205-312-7925
  • Fax: 205-990-2019
Mailing address:
  • Phone: 205-312-7925
  • Fax: 205-990-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPTH12550
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: