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General NPI Number Information
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NPI Number | 1942537691
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Entity Type | Individual
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Provider Name | CHRISTOPHER RUSH D.O.M. A.P.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 2121 5TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33713
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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 |
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Name |
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Credential |
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Telephone |
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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 | AP2115
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License Number State | FL
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