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General NPI Number Information
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NPI Number | 1962154765
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Entity Type | Individual
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Provider Name | JACOB VAUGHN BUNCH DPT
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Gender | Male
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Dates
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Enumeration Date | 01/23/2022
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 8536 CREEK VALLEY LN
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City | KNOXVILLE
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State | TN
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Zip | 37931-2030
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Country | US
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Telephone | 865-209-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 247 E WATT ST
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City | ALCOA
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State | TN
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Zip | 37701-2236
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Country | US
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Telephone | 865-984-2001
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Fax | 865-983-4194
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P20977
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License Number State | NC
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