Provider Demographics
NPI:1821177999
Name:RUSHER, EDWARD JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOHN
Last Name:RUSHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 AMOSKEAG ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3224
Mailing Address - Country:US
Mailing Address - Phone:603-624-8000
Mailing Address - Fax:603-629-9166
Practice Address - Street 1:55 AMOSKEAG ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3224
Practice Address - Country:US
Practice Address - Phone:603-624-8000
Practice Address - Fax:603-629-9166
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH111-1092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3122Medicare ID - Type Unspecified