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General NPI Number Information
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NPI Number | 1033887377
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Entity Type | Individual
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Provider Name | CYDNEY SHEA BUNN PT
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Gender | Female
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 406 ROY MARTIN RD STE 9
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City | GRAY
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State | TN
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Zip | 37615-2245
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Country | US
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Telephone | 423-477-1101
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Fax | 423-477-1102
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Provider Business Mailing Address
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Address Line | 202 WILMONT DR
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City | KINGSPORT
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State | TN
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Zip | 37663-2640
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Country | US
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Telephone | 423-765-7185
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Fax | 423-477-1101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 13665
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License Number State | TN
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