Provider Demographics
NPI:1609291103
Name:RUSHMORE, LINDSEY A (DOM, LAC, DIPL OM)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:A
Last Name:RUSHMORE
Suffix:
Gender:F
Credentials:DOM, LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9568 KINGS CHARTER DR STE 100A
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7955
Mailing Address - Country:US
Mailing Address - Phone:804-496-1675
Mailing Address - Fax:
Practice Address - Street 1:9568 KINGS CHARTER DR STE 100A
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7955
Practice Address - Country:US
Practice Address - Phone:804-496-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1121171100000X
VA171100000X
VA0121000801171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist