Individual
JOHNNY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
2350 N 3RD ST, UNION, NJ 07083-5049
(732) 423-1571
Mailing address
1770 LAWRENCE ST APT 4, RAHWAY, NJ 07065-5175
(732) 423-1571
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00187300
NJ
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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