Individual
JASON MICHAEL BUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOM, L.AC.
Contact information
Practice address
415 1/2 4TH ST, WILMETTE, IL 60091-2826
(847) 251-5225
(847) 251-5456
Mailing address
415 1/2 4TH ST, WILMETTE, IL 60091-2826
(847) 251-5225
(847) 251-5456
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198-000436
IL
Other
Enumeration date
06/13/2008
Last updated
06/13/2008
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