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NPI Code Detail

MEDICARE: ANDREW DAVID RODMAN PTA

MEDICARE: ANDREW DAVID RODMAN PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant001309IA

General Provider Information

NPI Number : 1578816096
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DAVID RODMAN PTA
Provider Business Mailing Address
First Line : 32280 RAILROAD HWY
Second Line :
City : NEOLA
State : IA
Zip : 51559-5530
Country : US
Telephone Number : 712-898-0074
Fax Number :
Provider Business Practice Location Address
First Line : 1010 LONGVIEW RD
Second Line :
City : MISSOURI VALLEY
State : IA
Zip : 51555-1227
Country : US
Telephone Number : 712-898-0074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2012
Last Update Date : 10/22/2012

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