Provider Demographics
NPI:1497748230
Name:BUSHMAN, JOANNE K (DC)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:K
Last Name:BUSHMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400A N SALISBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2137
Mailing Address - Country:US
Mailing Address - Phone:410-543-1230
Mailing Address - Fax:410-543-1263
Practice Address - Street 1:2400A N SALISBURY BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2137
Practice Address - Country:US
Practice Address - Phone:410-543-1230
Practice Address - Fax:410-543-1263
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV524111N00000X
MDS01461111N00000X
DEF10000287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T92504Medicare UPIN