Individual
CARISSA ARIELLE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6113 WEST KNOLLWOOD DR, APT 333, GRAND BLANC, MI 48439
(810) 986-9088
Mailing address
PO BOX 321273, FLINT, MI 48532-0022
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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