Individual
JEFF BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HAS
Contact information
Practice address
23773 US HIGHWAY 27, LAKE WALES, FL 33859-7802
(863) 949-4837
Mailing address
23773 US HIGHWAY 27, LAKE WALES, FL 33859-7802
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS5416
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS5416
STATE LICENSE
FL
Enumeration date
02/19/2019
Last updated
02/19/2019
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