Provider Demographics
NPI:1285199919
Name:BUSH, MELANIE RUTH (COMS)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:RUTH
Last Name:BUSH
Suffix:
Gender:F
Credentials:COMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 53RD ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5821
Mailing Address - Country:US
Mailing Address - Phone:406-868-8181
Mailing Address - Fax:406-454-8889
Practice Address - Street 1:724 53RD ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5821
Practice Address - Country:US
Practice Address - Phone:406-868-8181
Practice Address - Fax:406-454-8889
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider