Individual
ANNIE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3069 SUGAR RIDGE RD, PEMBERVILLE, OH 43450-9637
(416) 344-0008
Mailing address
3069 SUGAR RIDGE RD, PEMBERVILLE, OH 43450-9637
(416) 344-0008
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LPN112029
OH
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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