Individual provider · NPI-1

Robert Sisson Busch

Technician/Technologist, Optician · Tempe, AZ

NPI number1932380193
StatusActive
Last updated in NPPESNov 16, 2007

Details

NPI
1932380193
Entity type
Individual (NPI-1)
Name
Mr. Robert Sisson Busch
Sex
Male
Sole proprietor
No
Enumeration date
Nov 16, 2007
Last updated
Nov 16, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, Optician286AZYes

Practice location

1726 E Southern Ave
Suite 6
Tempe, AZ 85282-5686

Phone 480-839-3711 · Fax 480-456-3359

Mailing address

1726 E Southern Ave
Suite 6
Tempe, AZ 85282-5686

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