Bundy, Jack

Bundy, Jack is an individual health care provider with primary practice located at 187 W Schrock Rd , Westerville OH 43081-2890. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is his primary health care specialty. Bundy, Jack can be contacted via phone (614) 355-7500.

Contact Information

Primary practice address
187 W Schrock Rd Westerville OH 43081-2890
Phone: (614) 355-7500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1205304607
LBN Legal business name Bundy, Jack
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2018
Last updated Feb 20th, 2019 - about 6 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 1205304607 NPPES
Ohio MEDICAID 1473276

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