Individual
CHANCELOR BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 3RD ST NE, MASSILLON, OH 44646-5605
(330) 224-4823
(614) 468-1246
Mailing address
1720 FREDERICK AVE SW, CANTON, OH 44706-5314
(330) 224-4823
(330) 224-4823
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
7611206
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853687387
—
OH
Enumeration date
08/20/2025
Last updated
08/20/2025
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