Provider Demographics
NPI:1053526574
Name:RUSHFORD, WILLIAM LAWRENCE (BS, OTR)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LAWRENCE
Last Name:RUSHFORD
Suffix:
Gender:M
Credentials:BS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:90 PARK ISLAND DR
Mailing Address - Street 2:APARTMENT B
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2758
Mailing Address - Country:US
Mailing Address - Phone:810-342-4067
Mailing Address - Fax:
Practice Address - Street 1:MCLAREN REGIONAL MEDICAL CENTER
Practice Address - Street 2:401 S BALLENGER HWY
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3685
Practice Address - Country:US
Practice Address - Phone:810-342-4067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004837225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist