Individual
MR. ELBY BUSHONG IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4600 E WASHINGTON ST STE 300, PHOENIX, AZ 85034-1908
(516) 206-8900
Mailing address
1831 W TOPEKA DR, PHOENIX, AZ 85027-5349
(602) 561-6458
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AZ
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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