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Individual
MRS. JESSICA MARIE RODDY
Active
Individual
MRS. JESSICA MARIE RODDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014043L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013724060001
MEDICAL ASSISTANCE NUMBER
PA
Enumeration date
03/26/2007
Last updated
07/08/2007
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