Individual
JACKIE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N OREGON ST, DILLON, MT 59725-3624
(270) 576-2507
Mailing address
200 N OREGON ST # 3624, DILLON, MT 59725-3624
(270) 576-2507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-LIC-12283
MT
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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