Provider Demographics
NPI:1528302536
Name:BUNDZA, ALAN JAMES (DC, MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAMES
Last Name:BUNDZA
Suffix:
Gender:M
Credentials:DC, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 PICCADILLY ST
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:OH
Mailing Address - Zip Code:44405-1915
Mailing Address - Country:US
Mailing Address - Phone:330-717-2011
Mailing Address - Fax:
Practice Address - Street 1:74 PICCADILLY ST
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:OH
Practice Address - Zip Code:44405-1915
Practice Address - Country:US
Practice Address - Phone:330-717-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1113111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician