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Individual

TROY JAY BUSHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3200 CHANNING WAY STE 306, IDAHO FALLS, ID 83404-7546
(208) 535-4400
(208) 535-4404
Mailing address
PO BOX 741716, ATLANTA, GA 30374-1716

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
007103
AZ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
O-1521
ID

Other

Enumeration date
04/04/2013
Last updated
06/17/2021
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