MEDICARE: DR. BRIAN BUSHMAN DC

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
1	111NS0005X	Sports Physician Chiropractor	CHI-CHI-2913	MT

General Provider Information

NPI Number	:	1225449259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN BUSHMAN DC

Provider Business Mailing Address
First Line	:	10 AVANTA WAY STE 1
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-6874
Country	:	US
Telephone Number	:	406-652-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 MAIN ST STE 4
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-3320
Country	:	US
Telephone Number	:	406-969-4213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	09/17/2019

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Directions to “ DR. BRIAN BUSHMAN DC” Practice Location

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