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Individual

MAYNOR R RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
328 E BROAD ST APT 1, HAZLETON, PA 18201-6650
(570) 497-4070
(570) 300-1802
Mailing address
PO BOX 2438, HAZLETON, PA 18201-8438
(570) 497-4070
(570) 300-1802

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
343900000X
Non-emergency Medical Transport (VAN)
Primary
347B00000X
Bus
347C00000X
Private Vehicle

Other

Enumeration date
04/16/2019
Last updated
05/17/2019
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