Individual
MRS. MANDY KAY BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, ATC/LAT
Contact information
Practice address
1100 E 5TH ST, ANDERSON, IN 46012-3462
(765) 641-4493
Mailing address
17764 SUNDIAL CT, WESTFIELD, IN 46062-7640
(317) 379-3191
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001016A
IN
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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