Individual
MR. MARK R RODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
150 IDLE HOUR BLVD, OAKDALE, NY 11769-1906
(631) 244-1119
Mailing address
12 WINMAR LN, SAYVILLE, NY 11782-1371
(516) 805-5203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000828-1
NY
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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