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NPI Code Detail

MEDICARE: MRS. COLLEEN A. RUSHMORE P.T.

MEDICARE: MRS. COLLEEN A. RUSHMORE P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA00360000NJ
2225100000XPhysical TherapistPT005375-LPA

General Provider Information

NPI Number : 1841246147
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COLLEEN A. RUSHMORE P.T.
Provider Business Mailing Address
First Line : 160 RAMBLEWOOD RD
Second Line :
City : MOORESTOWN
State : NJ
Zip : 08057-2628
Country : US
Telephone Number : 856-778-0686
Fax Number :
Provider Business Practice Location Address
First Line : 3001 BRIDGEBORO RD
Second Line :
City : DELRAN
State : NJ
Zip : 08075-9700
Country : US
Telephone Number : 856-764-0494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 07/08/2007

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