Provider Demographics
NPI:1497900880
Name:PARTRIDGE-RUBUSH, ERICA JANE (LMT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JANE
Last Name:PARTRIDGE-RUBUSH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-1826
Mailing Address - Country:US
Mailing Address - Phone:239-848-5980
Mailing Address - Fax:
Practice Address - Street 1:18 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-1826
Practice Address - Country:US
Practice Address - Phone:239-848-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 50377225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist