Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 7831 | TX |
NPI | 1821326968 |
---|---|
Provider Name | Dr. Dawn Vlier Bush |
First Address | Humble, TX 77346-3548 |
Second Address | Humble, TX 77346-3548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2009 |
Last Update Date | 17/06/2012 |