Individual
RICHARD BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 W BROWN DEER RD, SUITE 202, BAYSIDE, WI 53217-1618
(414) 434-0461
Mailing address
500 W BROWN DEER RD, SUITE 202, BAYSIDE, WI 53217-1618
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16612
WV
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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