Healthcare Provider Details

I. General information

NPI: 1235810821
Provider Name (Legal Business Name): ERICA CARINA RODRIGUEZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERICA CARINA RAMOS

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2872 W 47TH AVE
KANSAS CITY KS
66103-3243
US

IV. Provider business mailing address

625 KENMOOR AVE SE STE 100
GRAND RAPIDS MI
49546-2395
US

V. Phone/Fax

Practice location:
  • Phone: 913-728-6158
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-07423
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: