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Individual

GEORGE BUSH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4050 BRIDGE VIEW DR, NORTH CHARLESTON, SC 29405-7488
(843) 579-4533
Mailing address
2530 FLAMINGO DR, CHARLESTON, SC 29414-5433
(843) 412-2572
(843) 637-3184

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5032
SC

Other

Enumeration date
10/29/2014
Last updated
10/29/2014
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