Individual
NICOLAS RIVERA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT, OTR/L
Contact information
Practice address
11202 W GARFIELD ST, AVONDALE, AZ 85323-7925
(480) 299-1626
Mailing address
11202 W GARFIELD ST, AVONDALE, AZ 85323-7925
(480) 299-1626
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-009589
AZ
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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