MEDICARE: MACIE R BUNGER PT

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
1	225100000X	Physical Therapist	4599	NE

General Provider Information

NPI Number	:	1093566820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACIE R BUNGER PT

Provider Business Mailing Address
First Line	:	715 N SAINT JOSEPH AVE
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-4451
Country	:	US
Telephone Number	:	402-460-5836
Fax Number	:	402-460-5829

Provider Business Practice Location Address
First Line	:	433 N WILLSON ST
Second Line	:
City	:	BLUE HILL
State	:	NE
Zip	:	68930-3507
Country	:	US
Telephone Number	:	402-756-2140
Fax Number	:	402-756-2139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2024
Last Update Date	:	03/29/2024

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Directions to “ MACIE R BUNGER PT” Practice Location

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