MEDICARE: DR. DENNIS M. BUSHMAN D.C.

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	111N00000X	Chiropractor	264	TN

General Provider Information

NPI Number	:	1346283819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS M. BUSHMAN D.C.

Provider Business Mailing Address
First Line	:	6718 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-4829
Country	:	US
Telephone Number	:	865-588-5321
Fax Number	:	865-588-7114

Provider Business Practice Location Address
First Line	:	6718 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-4829
Country	:	US
Telephone Number	:	865-588-5321
Fax Number	:	865-588-7114

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	05/06/2008

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