Individual
MICHELLE BUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12647 OLIVE BLVD, SUITE 600, SAINT LOUIS, MO 63141-6345
(800) 325-3982
Mailing address
554 COUNTY ROAD 385, SAN ANTONIO, TX 78253-6802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
03863
TX
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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