Provider Demographics
NPI:1356041164
Name:SCHUNK, SYDNEY FAITH (PTA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:FAITH
Last Name:SCHUNK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 E MAIN ST STE 7
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4534
Mailing Address - Country:US
Mailing Address - Phone:706-946-2035
Mailing Address - Fax:706-946-2036
Practice Address - Street 1:990 E MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4534
Practice Address - Country:US
Practice Address - Phone:706-946-2035
Practice Address - Fax:706-946-2036
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA7959225200000X
GACP014955A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant