| Doctor Name: | KEVIN CHARLES BUSHNELL |
| NPI Number: | 1316217557 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 030478 |
| Business Practice Address: | 1026 Hilton Parma Corners Rd Ste 1 Hilton, NY - 144689328 |
| Business Phone Number: | 5853928001 |
| Business Fax Number: | 5853928019 |
| Mailing Address: | 383 White Spruce Blvd, ROCHESTER |
| State: | NY |
| Postal Code: | 146231603 |
| Phone Number: | 5854426067 |
| Fax Number: | 5854426073 |
| NPI Enumeration Date: | 01/05/2012 |
| NPI Last Update Date: | 01/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 030478 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |