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NPI Code Detail

MEDICARE: HEATHER BUSSELL

MEDICARE: HEATHER BUSSELL
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 Assistant6666TN

General Provider Information

NPI Number : 1659846491
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER BUSSELL
Provider Business Mailing Address
First Line : 4755 MEDLEY AMONETTE RD
Second Line :
City : BUFFALO VALLEY
State : TN
Zip : 38548-5216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 120 PITCOCK LN
Second Line :
City : CELINA
State : TN
Zip : 38551-4058
Country : US
Telephone Number : 931-243-3139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2018
Last Update Date : 10/08/2018

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Directions to “ HEATHER BUSSELL ” Practice Location

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