Individual
DALE THEODORE BUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
530 IOWA AVE SE, STE.105, HURON, SD 57350-2864
(605) 352-2169
Mailing address
5000 E GRANT RD, UNIT #6, TUCSON, AZ 85712-2749
(520) 512-1038
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0031
SD
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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