Provider Demographics
NPI:1043108285
Name:RUSEN, JOHN WESLEY (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WESLEY
Last Name:RUSEN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CLEVELAND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-3304
Mailing Address - Country:US
Mailing Address - Phone:570-877-9500
Mailing Address - Fax:
Practice Address - Street 1:417 MARKET ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5418
Practice Address - Country:US
Practice Address - Phone:570-283-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG005855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor