Individual
JACKIE BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
320 HOSPITAL RD, CANTON, GA 30114-2432
(770) 479-5535
(770) 479-8821
Mailing address
320 HOSPITAL RD, CANTON, GA 30114-2432
(770) 479-5535
(770) 479-8821
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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