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BUSHMAN CHIROPRACTIC, LLC

Managed Care Organizations Point of Service

Provider NPI: 1598937773

Organization Information:
Organization Name:  BUSHMAN CHIROPRACTIC, LLC
Organization is not Subpart
Authorized Official:  SUSAN LYNN BUSHMAN  CHIROPRACTOR  314-413-7078

Practice Location:
14615 MANCHESTER RD STE. 104 BALLWIN, MO 63011-3790 US
Tel: 636-391-0424  Fax: 636-391-0437

Business Mailing Address:
14851 PHEASANT HILL CT  CHESTERFIELD, MO 63017-5411 US
Tel: 314-413-7078  Fax: --

NPI Information:
NPI: 1598937773
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y305S00000XManaged Care Organizations
Point of Service
MO2003003215

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 305S00000X

Type:

Classification:



Definition:



MEDICAL JOBS MO - Page 1

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