Individual
DR. JOHN STATE RUSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
1241 PROSPECT ST, APARTMENT 5, LA JOLLA, CA 92037-0000
(716) 481-0675
Mailing address
1241 PROSPECT ST, APARTMENT 5, LA JOLLA, CA 92037
(716) 481-0675
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
39331
CA
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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