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General NPI Number Information
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NPI Number | 1629137120
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Entity Type | Individual
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Provider Name | JOHN DAVID MCCUNE ATC
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1 AVENUE OF THE ARTS RATCLIFFE HALL
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2360
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Country | US
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Telephone | 732-921-7166
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Fax | 757-594-8737
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Provider Business Mailing Address
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Address Line | 890 HOLBROOK DR
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-8917
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Country | US
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Telephone | 757-594-7787
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Fax | 757-594-8737
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00102600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126002684
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License Number State | VA
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