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NPI Code Detail

MEDICARE: JACQUELYN BUSH LMT

MEDICARE: JACQUELYN BUSH LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist2306MS

General Provider Information

NPI Number : 1013865898
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN BUSH LMT
Provider Business Mailing Address
First Line : 807A HOLCOMB BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-3943
Country : US
Telephone Number : 775-340-9918
Fax Number :
Provider Business Practice Location Address
First Line : 807A HOLCOMB BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-3943
Country : US
Telephone Number : 775-340-9918
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ JACQUELYN BUSH LMT” Practice Location

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