Provider Demographics
NPI:1033887377
Name:BUNN, CYDNEY SHEA (PT)
Entity Type:Individual
Prefix:MRS
First Name:CYDNEY
Middle Name:SHEA
Last Name:BUNN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 WILMONT DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2640
Mailing Address - Country:US
Mailing Address - Phone:423-765-7185
Mailing Address - Fax:423-477-1101
Practice Address - Street 1:406 ROY MARTIN RD STE 9
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-2245
Practice Address - Country:US
Practice Address - Phone:423-477-1101
Practice Address - Fax:423-477-1102
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN136652251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic