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General NPI Number Information
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NPI Number | 1740648187
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Entity Type | Organization
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Legal Business Name | RODRIGO D. RODRIGUEZ
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Dates
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Enumeration Date | 01/31/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 1573 S CATAWBA CIR
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City | AURORA
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State | CO
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Zip | 80018-6012
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Country | US
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Telephone | 720-473-9791
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Fax |
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Provider Business Mailing Address
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Address Line | 1573 S CATAWBA CIR
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City | AURORA
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State | CO
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Zip | 80018-6012
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Country | US
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Telephone | 720-473-9791
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RODRIGO D RODRIGUEZ
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Credential | PT,DPT,CWS,WCC
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Telephone | 720-473-9791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 6842
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License Number State | CO
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