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Individual

MARY COURTNEY BUSHONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPH

Contact information

Practice address
709 N MAIN ST, TOMPKINSVILLE, KY 42167-1129
(270) 407-5045
(270) 407-5151
Mailing address
709 N MAIN ST, TOMPKINSVILLE, KY 42167-1129
(270) 407-5045
(270) 407-5151

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14288
KY

Other

Enumeration date
12/05/2019
Last updated
12/05/2019
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