Provider Demographics
NPI:1942537691
Name:RUSH, CHRISTOPHER (DOM AP)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:RUSH
Suffix:
Gender:M
Credentials:DOM AP
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8297 CHAMPIONS GATE BLVD # 330
Mailing Address - Street 2:
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8387
Mailing Address - Country:US
Mailing Address - Phone:407-505-7904
Mailing Address - Fax:407-604-6416
Practice Address - Street 1:2121 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713
Practice Address - Country:US
Practice Address - Phone:407-505-7904
Practice Address - Fax:407-604-6416
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2115171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist