Individual
MIRIAH RODERIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
188 EASTERN AVE, AUGUSTA, ME 04330-5928
(207) 622-3121
Mailing address
19 GRIMMAULD PL, SIDNEY, ME 04330-2656
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA4066
ME
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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