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General NPI Number Information
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NPI Number | 1346807039
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Entity Type | Organization
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Legal Business Name | RUSH MEDICAL LLC
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 2121 5TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33713-8013
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Country | US
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Telephone | 407-505-7904
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Fax | 407-604-6416
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Provider Business Mailing Address
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Address Line | 8297 CHAMPIONS GATE BLVD # 330
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City | CHAMPIONS GATE
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State | FL
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Zip | 33896-8387
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Country | US
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Telephone | 407-505-7904
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Fax | 407-604-6416
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER RUSH
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Credential | D,O,M,
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Telephone | 407-505-7904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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