Individual
JUAN ANTONIO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 S MACDONALD, MESA, AZ 85210-1310
(480) 969-1471
(480) 269-9426
Mailing address
4558 E DUBLIN ST, GILBERT, AZ 85295-5819
(623) 850-0883
(623) 815-1222
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
LP046695
AZ
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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