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General NPI Number Information
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NPI Number | 1104612308
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Entity Type | Individual
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Provider Name | MAGGIE BUSH OTR
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Gender | Female
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 101 SEXTON WAY
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City | MIDWAY
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State | KY
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Zip | 40347-7800
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Country | US
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Telephone | 859-846-4663
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Fax |
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Provider Business Mailing Address
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Address Line | 3364 KY HIGHWAY 1842 N
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City | CYNTHIANA
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State | KY
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Zip | 41031-7626
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Country | US
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Telephone | 859-327-9385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 174827
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License Number State | KY
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