Individual
IRIS DEEPTI BHUSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
15 HUCKLEBERRY LN, MALAKOFF, TX 75148-4734
(903) 780-9306
Mailing address
15 HUCKLEBERRY LN, MALAKOFF, TX 75148-4734
(903) 780-9306
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2083198
TX
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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