Individual
ELIZABETH RUSTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4036 HIGHWAY 8, CLEVELAND, MS 38732-8551
(662) 843-4014
Mailing address
PO BOX 428, ORCHARD PARK, NY 14127-0428
(716) 662-4955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6773
MS
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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