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Individual

CRYSTAL GALE BUSH - CALLOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2625 PALMETTO RD, MOUNT DORA, FL 32757-2422
(352) 989-2191
Mailing address
2625 PALMETTO RD, MOUNT DORA, FL 32757-2422
(352) 989-2191

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26166
FL

Other

Enumeration date
03/21/2017
Last updated
09/07/2021
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