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NPI Code Detail

MEDICARE: JOHN ANDREW BUSH PTA

MEDICARE:   JOHN ANDREW BUSH  PTA
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
1225200000XPhysical Therapy Assistant40QB00210400NJ

General Provider Information

NPI Number : 1194016691
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ANDREW BUSH PTA
Provider Business Mailing Address
First Line : 1031 SHORE RD
Second Line : #B
City : LINWOOD
State : NJ
Zip : 08221-2440
Country : US
Telephone Number : 609-602-0673
Fax Number :
Provider Business Practice Location Address
First Line : 1031 SHORE RD
Second Line : #B
City : LINWOOD
State : NJ
Zip : 08221-2440
Country : US
Telephone Number : 609-602-0673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2011
Last Update Date : 05/02/2011

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Directions to “ JOHN ANDREW BUSH PTA” Practice Location

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