Provider Demographics
NPI:1548941685
Name:BUNSEY, LUCINDA SHOAFF
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:SHOAFF
Last Name:BUNSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 CLEVELAND RD E
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-9704
Mailing Address - Country:US
Mailing Address - Phone:144-091-5829
Mailing Address - Fax:
Practice Address - Street 1:5007 CLEVELAND RD E
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:OH
Practice Address - Zip Code:44839-9704
Practice Address - Country:US
Practice Address - Phone:144-091-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty