Provider Demographics
NPI:1063709699
Name:RUSHING, DEREK KEITH (DPT)
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:KEITH
Last Name:RUSHING
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:3105 NEW COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2892
Mailing Address - Country:US
Mailing Address - Phone:678-520-0474
Mailing Address - Fax:770-271-7426
Practice Address - Street 1:3625 BRASELTON HWY STE 204
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-4695
Practice Address - Country:US
Practice Address - Phone:770-271-7492
Practice Address - Fax:770-271-7426
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist