Individual
HEATHER BUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 PITCOCK LN, CELINA, TN 38551-4058
(931) 243-3139
Mailing address
4755 MEDLEY AMONETTE RD, BUFFALO VALLEY, TN 38548-5216
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6666
TN
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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