Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CHI-CHI-2913 | MT |
NPI | 1225449259 |
---|---|
Provider Name | Dr. Brian Bushman |
First Address | Billings, MT 59102-6874 |
Second Address | Billings, MT 59105-3320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2014 |
Last Update Date | 17/09/2019 |