Individual
EDGAR LIONEL RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6343 WHITE HERON CT, LAS VEGAS, NV 89139-7233
(702) 824-3323
Mailing address
6343 WHITE HERON CT, LAS VEGAS, NV 89139-7233
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0851
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7028243323
—
NV
Enumeration date
07/09/2021
Last updated
07/09/2021
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