Individual
MARY L BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5194 NTH TUETONIA AVE, MILW, WI 53209
(414) 212-8985
(414) 212-8985
Mailing address
5875 NTH 60 STREET, MILWAUKEE, WI 53218
(414) 212-8985
(414) 212-8985
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
WI
376G00000X
Nursing Home Administrator
—
WI
376K00000X
Nurse's Aide
—
WI
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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