Individual
DIANA JOELLE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
401 OWEN LN, WACO, TX 76710-5558
(254) 495-2550
Mailing address
206 BIRCH ST, WACO, TX 76705-1904
(254) 495-2550
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2114580
TX
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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