Provider Demographics
NPI:1366871261
Name:MUNSON, DAVID (LPTA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:MUNSON
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20530 SUGAR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-8469
Mailing Address - Country:US
Mailing Address - Phone:812-584-3162
Mailing Address - Fax:
Practice Address - Street 1:135 WEST STATE ROUTE 56
Practice Address - Street 2:SWISS VILLA NURSING AND REHABILITATION
Practice Address - City:VEVAY
Practice Address - State:IN
Practice Address - Zip Code:47043
Practice Address - Country:US
Practice Address - Phone:812-427-2803
Practice Address - Fax:812-427-2646
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060033503A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant