Provider Demographics
NPI:1154672343
Name:RUSHING, GUNILLA MARGARETA
Entity Type:Individual
Prefix:
First Name:GUNILLA
Middle Name:MARGARETA
Last Name:RUSHING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GUNILLA
Other - Middle Name:MARGARETA
Other - Last Name:NAESLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:178 MACNEIL PL
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1920
Mailing Address - Country:US
Mailing Address - Phone:719-583-9689
Mailing Address - Fax:719-583-9689
Practice Address - Street 1:178 MACNEIL PL
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1920
Practice Address - Country:US
Practice Address - Phone:719-583-9689
Practice Address - Fax:719-583-9689
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist