MEDICARE: DR. KARLEEANN BUSH DPT

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	225100000X	Physical Therapist	PT38380	FL
2	225100000X	Physical Therapist	4907	NV

General Provider Information

NPI Number	:	1235884065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARLEEANN BUSH DPT

Provider Business Mailing Address
First Line	:	6524 CORONADO CANYON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-2878
Country	:	US
Telephone Number	:	435-229-6146
Fax Number	:

Provider Business Practice Location Address
First Line	:	6524 CORONADO CANYON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-2878
Country	:	US
Telephone Number	:	435-229-6146
Fax Number	:

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

Provider Enumeration Date	:	02/21/2022
Last Update Date	:	07/17/2025

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