Antonio Bush
Individual provider Active NPI Orthotic Fitter · Butler, AL
NPI 1497501522 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1497501522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthotic Fitter 225000000X
- Practice address
- 502 S Mulberry Ave
Butler, AL 36904-2804 - Phone
- (601) 934-5717
- NPI assigned
- Apr 29, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | Yes |
Addresses
Primary practice location
502 S Mulberry Ave
Butler, AL 36904-2804
Mailing address
502 S Mulberry Ave
Butler, AL 36904-2804
Phone (601) 934-5717
Other providers in Butler, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.