Individual
SAMANTHA BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, CES
Contact information
Practice address
1015 UNION ST, BOONE, IA 50036-4821
(319) 415-1212
Mailing address
405 N OAK ST, JEFFERSON, IA 50129-1429
(319) 415-1212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000935
IA
Other
Enumeration date
11/09/2011
Last updated
05/26/2016
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