Individual
REBECCA DYAN BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
104 E CHEROKEE ST, MEDFORD, OK 73759-1210
(580) 404-1500
(580) 404-1504
Mailing address
104 E CHEROKEE ST, MEDFORD, OK 73759-1210
(580) 404-1500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2181
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200775830B
—
OK
Enumeration date
02/17/2016
Last updated
05/17/2022
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