Provider Demographics
NPI:1689079048
Name:BUNN, EDWARD N (PT)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:N
Last Name:BUNN
Suffix:
Gender:M
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:PO BOX 208 19189 ST RT 136
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697-1231
Mailing Address - Country:US
Mailing Address - Phone:937-695-0839
Mailing Address - Fax:937-695-1441
Practice Address - Street 1:10717 FINCASTLE WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697-9495
Practice Address - Country:US
Practice Address - Phone:513-313-2307
Practice Address - Fax:937-695-0520
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist