NPI Profile for GAGE BUSH in STURGIS, SD.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI # | 1366181075 |
|
| Status | Active | |
| Credentials | ACT | |
| Entity | Individual | |
| Enumeration date | 06/01/2022 | |
| Last updated | 06/01/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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GAGE BUSH
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