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Individual

RYAN OWEN BUNDREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADAC II

Contact information

Practice address
703 HURRICANE CREEK RD, WAYNESBORO, TN 38485-2226
(931) 279-6378
Mailing address
703 HURRICANE CREEK RD, WAYNESBORO, TN 38485-2226
(931) 279-6378

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1408
TN

Other

Enumeration date
03/04/2021
Last updated
06/13/2025
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