Individual
TIMOTHY BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
840 INTERSTATE DR, GRAYSON, KY 41143-1768
(606) 474-5151
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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