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General NPI Number Information
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NPI Number | 1225219991
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Entity Type | Organization
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Legal Business Name | BRIAN J. RODRIGUEZ, PT, PC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 151 E 5600 S STE 208
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City | MURRAY
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State | UT
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Zip | 84107-8146
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Country | US
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Telephone | 801-808-9384
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Fax |
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Provider Business Mailing Address
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Address Line | 450 E ADALEY AVE
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City | MURRAY
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State | UT
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Zip | 84107-6562
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Country | US
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Telephone | 801-808-9384
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | BRIAN J RODRIGUEZ
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Credential | PT, DPT, OCS
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Telephone | 801-808-9384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1195562401
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License Number State | UT
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