Individual
ANDREA BUSHWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3639 5TH AVE N, SAINT PETERSBURG, FL 33713-7503
(727) 803-6931
Mailing address
3639 5TH AVE NORTH, SAINT PETERSBURG, FL 33713
(727) 803-6931
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
FL
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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