Provider Demographics
NPI:1881015204
Name:BUNING, SHAUN (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:BUNING
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 BLUEBIRD LN
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3124
Mailing Address - Country:US
Mailing Address - Phone:662-202-7992
Mailing Address - Fax:
Practice Address - Street 1:401 W MARTINTOWN RD STE 169
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-6136
Practice Address - Country:US
Practice Address - Phone:803-441-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist