Individual
MARISSA L BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
309 BLACK OAK RIDGE RD, WAYNE, NJ 07470-6504
(973) 956-2900
(973) 956-7900
Mailing address
1 W RIDGEWOOD AVE, SUITE 104, PARAMUS, NJ 07652-2359
(201) 652-1415
(201) 652-0391
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA01360300
NJ
Other
Enumeration date
08/04/2010
Last updated
01/29/2014
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