Provider Demographics
NPI:1689678104
Name:BUSCH, DANNY (DC)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:
Last Name:BUSCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 E VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-7039
Mailing Address - Country:US
Mailing Address - Phone:941-412-3800
Mailing Address - Fax:941-486-0390
Practice Address - Street 1:808 VENICE AVE E
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-7165
Practice Address - Country:US
Practice Address - Phone:941-412-3800
Practice Address - Fax:941-486-0390
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70247ZOtherMEDICARE PTAN
FL657993OtherUNITED HEALTHCARE
FL70247OtherBLUE CROSS
FL70247ZMedicare PIN
FL70247ZOtherMEDICARE PTAN