Individual
KELSIE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12637 S 265 W, DRAPER, UT 84020-5400
(801) 998-8428
Mailing address
12637 S 265 W, DRAPER, UT 84020-5400
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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