Individual
THERESA BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
27 E ELM ST, TAMAQUA, PA 18252-1431
(570) 730-7119
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
9915828
PA
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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