Provider Demographics
NPI:1497970594
Name:BUSSEY, CHRISTOPHER BRADLEY (ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRADLEY
Last Name:BUSSEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 BAUGH LN NE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3917
Mailing Address - Country:US
Mailing Address - Phone:276-628-5508
Mailing Address - Fax:
Practice Address - Street 1:284 BAUGH LN NE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3917
Practice Address - Country:US
Practice Address - Phone:276-628-5508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260000202255A2300X
TNAT00000002372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer