Individual
JASON RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, LAT, ATC
Contact information
Practice address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 721-7236
Mailing address
6832 CALDER ST, LAKE CHARLES, LA 70605-0163
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200098
LA
Other
Enumeration date
10/03/2012
Last updated
11/22/2024
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