Individual
MS. JESSICA MARIE BUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
206 N RANDOLPH ST, SUITE 426, CHAMPAIGN, IL 61820-3949
(217) 819-0023
Mailing address
206 N RANDOLPH ST, SUITE 426, CHAMPAIGN, IL 61820-3949
(217) 819-0023
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227010013
IL
Other
Enumeration date
01/18/2008
Last updated
07/20/2015
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