Individual
MR. RODRIGUE GNINAZE SAGBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3697
Mailing address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
134501
IA
Other
Enumeration date
04/11/2025
Last updated
09/04/2025
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