Basic Information
| Provider Information | |||||||||
| NPI: | 1003151077 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | RODRIGO | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | PT,DPT,CWS,WCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1573 S CATAWBA CIR | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800186012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204739791 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1573 S CATAWBA CIR | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800186012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204739791 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2012 | ||||||||
| LastUpdateDate: | 03/28/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 6842 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.