Individual
JUSTIN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
411 W ROAD 1 N STE A, CHINO VALLEY, AZ 86323-5943
(928) 636-8521
Mailing address
411 W ROAD 1 N STE A, CHINO VALLEY, AZ 86323-5943
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11925A
AZ
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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