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NPI Code Detail

MEDICARE: NOAH BUSHMAN DPT, PT

MEDICARE: NOAH BUSHMAN DPT, PT
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
1225100000XPhysical Therapist2305217707VA

General Provider Information

NPI Number : 1457282451
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOAH BUSHMAN DPT, PT
Provider Business Mailing Address
First Line : 2200 S MAIN ST STE B
Second Line :
City : BLACKSBURG
State : VA
Zip : 24060-6620
Country : US
Telephone Number : 540-774-0729
Fax Number : 540-774-0862
Provider Business Practice Location Address
First Line : 4600 BRAMBLETON AVE STE B
Second Line :
City : ROANOKE
State : VA
Zip : 24018-3437
Country : US
Telephone Number : 540-774-0729
Fax Number : 540-774-0862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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