Tyquanda Bush
Technician, Other in Flint, MI. Individual provider (NPI-1).
NPI number1366100737
StatusActive
Last updated in NPPESDec 2, 2021
Details
- NPI
- 1366100737
- Entity type
- Individual (NPI-1)
- Name
- Tyquanda Bush
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 2, 2021
- Certification date
- Dec 2, 2021
- Last updated
- Dec 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
2284 S Ballenger Hwy Ste GFlint, MI 48503-3446
Phone 810-221-7871
Mailing address
2284 S Ballenger Hwy Ste GFlint, MI 48503-3446
Phone 810-221-7871
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