Individual
MARY JO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
141A MESCALERO TRAIL, RUIDOSO, NM 88345
(575) 257-4753
(575) 257-4753
Mailing address
141A MESCALERO TRAIL, RUIDOSO, NM 88345
(575) 257-4753
(575) 257-4753
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1528
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B9609
—
NM
Enumeration date
10/20/2006
Last updated
09/21/2009
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