Individual
CONNIE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 POPPYFIELD FARM DR, GOOD HOPE, GA 30641-2137
(912) 245-9637
Mailing address
200 POPPYFIELD FARM DR, GOOD HOPE, GA 30641-2137
(912) 245-9637
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000953
GA
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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