Individual
BRIDGET ROSE BUSHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3853 FOREST PARK AVE APT 333, SAINT LOUIS, MO 63108-3361
(618) 975-3386
Mailing address
3853 FOREST PARK AVE APT 333, SAINT LOUIS, MO 63108-3361
(618) 975-3386
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
04/04/2018
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