Healthcare Provider Details
I. General information
NPI: 1710811302
Provider Name (Legal Business Name): MORGAN RUST PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
846 W FOOTHILL BLVD STE C
UPLAND CA
91786-3784
US
IV. Provider business mailing address
6331 SILVERWOOD PL
RANCHO CUCAMONGA CA
91737-7767
US
V. Phone/Fax
- Phone: 909-985-8686
- Fax:
- Phone: 909-985-8686
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 310242 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: