Individual
LUZBERTO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 W 87TH AVE, MERRILLVILLE, IN 46410-6177
(219) 756-0744
Mailing address
7780 CAROLINA PL, MERRILLVILLE, IN 46410-5629
(219) 689-2681
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002840A
IN
225200000X
Physical Therapy Assistant
160003862
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06002840A
PTA LICENSE
IN
01
—
160003862
PTA LICENSE
IL
Enumeration date
08/21/2019
Last updated
08/21/2019
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