Individual
KIMBERLY M BUSHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 W MAIN ST, WOODVILLE, OH 43469-9723
(419) 724-5820
Mailing address
4235 SECOR RD, TOLEDO, OH 43623-4231
(419) 473-3561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084436
—
OH
Enumeration date
10/07/2005
Last updated
06/02/2025
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