Individual
DOUGLAS MICHAEL BUSHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
109 N MAIN AVE, ERWIN, TN 37650-1255
(423) 743-7105
Mailing address
1511 KINGS ROW, JOHNSON CITY, TN 37604-3642
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9957
TN
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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