Provider Demographics
NPI:1841800117
Name:RUSH, ROBERT TUCKER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TUCKER
Last Name:RUSH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7237
Mailing Address - Fax:423-933-1996
Practice Address - Street 1:3630 THOMPSON BRIDGE RD STE 4
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-1523
Practice Address - Country:US
Practice Address - Phone:678-971-4235
Practice Address - Fax:678-971-4276
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist