Provider Demographics
NPI:1841484847
Name:GUNN, JOHNNA F (LMT)
Entity type:Individual
Prefix:
First Name:JOHNNA
Middle Name:F
Last Name:GUNN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 SPRUCE HILL DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1812
Mailing Address - Country:US
Mailing Address - Phone:330-966-3966
Mailing Address - Fax:
Practice Address - Street 1:4906 SPRUCE HILL DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-1812
Practice Address - Country:US
Practice Address - Phone:330-966-3966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-01
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6077225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist