Individual
JONATHAN LAVAN BUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
267 N SPRING CREEK PKWY, PROVIDENCE, UT 84332-9775
(435) 792-9400
Mailing address
4949 S 3535 W, TAYLORSVILLE, UT 84129-2947
(435) 757-7546
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/20/2014
Last updated
06/05/2022
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