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General NPI Number Information
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NPI Number | 1043330756
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Entity Type | Organization
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Legal Business Name | CHRISTINA M RUST DPT & ASSOCIATES PC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 801 PINE ST STE 2
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City | SANDPOINT
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State | ID
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Zip | 83864-1682
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Country | US
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Telephone | 208-290-2856
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Fax | 208-290-2856
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Provider Business Mailing Address
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Address Line | 801 PINE ST STE 2
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City | SANDPOINT
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State | ID
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Zip | 83864-1682
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Country | US
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Telephone | 208-290-2856
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Fax | 208-290-2856
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Authorized Official
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Title or Position | OWNER/ PHYSICAL THERAPIST
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Name | CHRISTINA MARIE RUST
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Credential | DPT, PA-C
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Telephone | 208-290-2856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT1097
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License Number State | ID
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