Individual
KELLY BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32910 W 13 MILE RD, BLDG. A, SUITE 100, FARMINGTON HILLS, MI 48334-1980
(248) 539-3390
Mailing address
32910 W 13 MILE RD, BLDG. A, SUITE 100, FARMINGTON HILLS, MI 48334-1980
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
L2551518
MI
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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