Provider Demographics
NPI:1700210333
Name:CUSH, CHRISTOPHER BRANDON (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRANDON
Last Name:CUSH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:BRANDON
Other - Last Name:CUSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:797 E LANCASTER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3315
Mailing Address - Country:US
Mailing Address - Phone:610-269-5070
Mailing Address - Fax:215-504-2141
Practice Address - Street 1:797 E LANCASTER AVE STE 2
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3315
Practice Address - Country:US
Practice Address - Phone:610-269-5070
Practice Address - Fax:215-504-2141
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT022977OtherPHYSICAL THERAPY