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Organization
CLUB MANOR CLINIC, INC.
Active
Organization
CLUB MANOR CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DOUGLAS BUSCH D.C. (PRESIDENT)
(719) 544-7744
Entity
Organization
Contact information
Practice address
1805 FORTINO BLVD, PUEBLO, CO 81008-1851
(719) 544-7744
(719) 584-2853
Mailing address
1805 FORTINO BLVD, PUEBLO, CO 81008-1851
(719) 544-7744
(719) 584-2853
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5101
CO
Other
Enumeration date
03/05/2007
Last updated
11/24/2008
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