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General NPI Number Information
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NPI Number | 1205100641
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Entity Type | Organization
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Legal Business Name | BRIAN C. RUSH D. C. P. A.
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 10830 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5205
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Country | US
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Telephone | 954-432-5006
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Fax | 954-435-3777
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Provider Business Mailing Address
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Address Line | 10830 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5205
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Country | US
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Telephone | 954-432-5006
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Fax | 954-435-3777
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN C. RUSH
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Credential | D. C.
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Telephone | 954-432-5006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8137
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License Number State | FL
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