Individual
DEIDRA L BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 CHIPPEWA MALL DR, CHIPPEWA FALLS, WI 54729-5034
(715) 720-3780
Mailing address
475 CHIPPEWA MALL DR, CHIPPEWA FALLS, WI 54729-5034
(715) 720-3780
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
304253-31
WI
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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