Individual
MR. EDGAR OMAR RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
USS BATAAN LHD-5, FPO AE, NORFOLK, VA 09554-1657
(757) 445-6344
Mailing address
20290 APRICOT LN, CALDWELL, ID 83607-9480
(208) 602-7014
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
7920
NC
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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