Individual
BLAINE BUNCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1304 WALNUT ST, WAYNESBORO, MS 39367-2232
(601) 735-9025
Mailing address
754 BUCKATUNNA CHICORA CLARA RD, WAYNESBORO, MS 39367-7381
(601) 381-1719
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2524
MS
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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