Provider Demographics
NPI:1235317264
Name:ZUNK, GESSIE RENEE (PT)
Entity Type:Individual
Prefix:
First Name:GESSIE
Middle Name:RENEE
Last Name:ZUNK
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 1:2815 DUSTIN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3495
Mailing Address - Country:US
Mailing Address - Phone:419-693-0676
Mailing Address - Fax:419-693-0807
Practice Address - Street 1:2815 DUSTIN RD
Practice Address - Street 2:SUITE B
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3495
Practice Address - Country:US
Practice Address - Phone:419-693-0676
Practice Address - Fax:419-693-0807
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.012008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist