Provider Demographics
NPI:1962637199
Name:RUSHER, KATHERINE M (DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:RUSHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MACARTHUR BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2920
Mailing Address - Country:US
Mailing Address - Phone:219-836-1060
Mailing Address - Fax:
Practice Address - Street 1:801 MACARTHUR BLVD STE 304
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2920
Practice Address - Country:US
Practice Address - Phone:219-836-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205862225100000X
IN05009641A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist