Individual
JACQUELINE REBECA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9705 LIBERIA AVE, MANASSAS, VA 20110-1743
(703) 680-7950
Mailing address
360 MOSEBY CT, MANASSAS PARK, VA 20111-2098
(703) 656-6263
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306606002
VA
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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