Individual
JESSICA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, CES
Contact information
Practice address
10215 N 43RD AVE, PHOENIX, AZ 85051-1025
(623) 810-9408
Mailing address
5401 E VAN BUREN ST, APT 2064, PHOENIX, AZ 85008-3497
(361) 227-0979
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1039
AZ
2255A2300X
Athletic Trainer
Primary
2000006460
TX
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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