Provider Demographics
NPI:1962059410
Name:WAITE, SUNNY RUSH (DPT)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:RUSH
Last Name:WAITE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SUNNY
Other - Middle Name:CALISTE
Other - Last Name:RUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8205 PRESIDENTS DR
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8621
Mailing Address - Country:US
Mailing Address - Phone:717-839-2188
Mailing Address - Fax:717-565-1104
Practice Address - Street 1:6600 POPLAR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1105
Practice Address - Country:US
Practice Address - Phone:601-482-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT6769225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist