Individual
BRYAN BUSSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
641 W WARNER RD, GILBERT, AZ 85233-7266
(480) 722-9828
Mailing address
641 W WARNER RD, GILBERT, AZ 85233-7266
(857) 200-2508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6190
AZ
Other
Enumeration date
09/27/2015
Last updated
01/06/2016
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