Provider Demographics
NPI:1104900091
Name:BUSCH MISKY, EMILY C (DC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:C
Last Name:BUSCH MISKY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 E WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:CUBA CITY
Mailing Address - State:WI
Mailing Address - Zip Code:53807
Mailing Address - Country:US
Mailing Address - Phone:608-744-2725
Mailing Address - Fax:608-744-2725
Practice Address - Street 1:218 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:CUBA CITY
Practice Address - State:WI
Practice Address - Zip Code:53807
Practice Address - Country:US
Practice Address - Phone:608-744-2725
Practice Address - Fax:608-744-2725
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3618012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38921500Medicaid
U79363Medicare UPIN
000035675Medicare ID - Type Unspecified