Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 7673 | TN |
N | 2251N0400X | Physical Therapist - Neurology | 7673 | TN |
NPI | 1538407432 |
---|---|
Provider Name | Mrs. Shelby Bush |
First Address | Franklin, TN 37067-7242 |
Second Address | Franklin, TN 37067-7242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2013 |
Last Update Date | 28/01/2013 |