Individual
AMANDA BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 NORTH ST, SUITE #1-A, NACOGDOCHES, TX 75965-2472
(936) 569-8585
(936) 569-8525
Mailing address
PO BOX 1035, CENTER, TX 75935-1035
(936) 590-4464
(936) 590-4468
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1001013
TX
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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