Provider Demographics
NPI:1235326182
Name:RUSH, SUSAN (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:RUSH
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 E GIRARD AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2784
Mailing Address - Country:US
Mailing Address - Phone:720-214-2549
Mailing Address - Fax:303-744-7876
Practice Address - Street 1:777 E GIRARD AVE STE 250
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2784
Practice Address - Country:US
Practice Address - Phone:720-214-2549
Practice Address - Fax:303-744-7876
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO231246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic