Individual
MISS LISA MARIE BUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 N SANDUS KY AVE, BURYRUS, OH 44820
(419) 562-4677
Mailing address
71 VILLAGE GATE BLVD, DELAWARE, OH 43015
(614) 580-0470
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10171
OH
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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