Individual
MS. KRISTINE A BUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
435 1ST ST, BELGIUM, WI 53004-9305
(847) 971-7999
Mailing address
435 1ST ST, BELGIUM, WI 53004-9305
(847) 971-7999
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10062-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10062-24
PT STATE LIC #
WI
05
—
40453000
—
WI
Enumeration date
01/30/2007
Last updated
07/09/2007
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