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Individual

CRAIG ALLEN RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
861 N MAIN ST, RICHFIELD, UT 84701-1840
(435) 558-7031
(702) 576-9609
Mailing address
861 N MAIN ST, RICHFIELD, UT 84701-1840

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12256467-1206
UT
363AM0700X
Medical Physician Assistant
PA1471
NV

Other

Enumeration date
12/12/2013
Last updated
09/21/2021
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