Provider Demographics
NPI:1205959541
Name:BUSCH, BETHLYN (OMD, AP)
Entity type:Individual
Prefix:DR
First Name:BETHLYN
Middle Name:
Last Name:BUSCH
Suffix:
Gender:F
Credentials:OMD, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 29TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-5116
Mailing Address - Country:US
Mailing Address - Phone:561-659-7895
Mailing Address - Fax:
Practice Address - Street 1:526 29TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-5116
Practice Address - Country:US
Practice Address - Phone:561-659-7895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP556171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist