Provider Demographics
NPI:1790200939
Name:HENDRICKS, RUSH DAVIS (DPT)
Entity type:Individual
Prefix:
First Name:RUSH
Middle Name:DAVIS
Last Name:HENDRICKS
Suffix:
Gender:M
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:PO BOX 392977
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-3869
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:303-840-8928
Practice Address - Street 1:5570 POWERS CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7100
Practice Address - Country:US
Practice Address - Phone:719-785-1696
Practice Address - Fax:719-785-1699
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11546225100000X
TX1318973225100000X
COPTL.0019263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist