Individual
KENNETH RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3899 MID RIVERS MALL DR, SAINT PETERS, MO 63376-2870
(314) 575-1212
Mailing address
PO BOX 510096, SAINT LOUIS, MO 63151-0096
(314) 575-1212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2001032303
MO
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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