Individual
IVET LLOANSI RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
500 E COLLEGE ST, MARSHALL, MO 65340-3109
(660) 865-9366
Mailing address
500 E COLLEGE ST, MARSHALL, MO 65340-3109
(660) 865-9366
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MO
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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