Individual
BLAKELYN L BUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4700 MEMORIAL DR STE 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
Mailing address
4700 MEMORIAL DR STE 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036.159450
IL
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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