Individual
CALLIE LUCINDA BUSHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3950 NEWMAN RD, JOPLIN, MO 64801-1512
(903) 944-9555
Mailing address
3950 NEWMAN RD, JOPLIN, MO 64801-1512
(903) 944-9555
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2024000700
MO
Other
Enumeration date
02/03/2021
Last updated
06/24/2024
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