Bundrick, Jeffrey D

Bundrick, Jeffrey D is an individual health care provider with primary practice located at 2900 Doolittle Dr , Ellsworth Afb SD 57706-4821. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Bundrick, Jeffrey D can be contacted via phone (605) 385-6700.

Contact Information

Primary practice address
2900 Doolittle Dr Ellsworth Afb SD 57706-4821
Phone: (605) 385-6700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 2012027617 Missouri

Profile Details

NPI number 1366928350
LBN Legal business name Bundrick, Jeffrey D
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2018
Last updated Aug 2nd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366928350 NPPES
Missouri Other 2012027617 PHYSICAL THERAPY LICENSE

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