Individual
ASHLEY RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 NE CRESCENT AVE, PEORIA, IL 61606-1901
(309) 672-4670
Mailing address
112 NE CRESCENT AVE, PEORIA, IL 61606-1901
(309) 672-4670
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010770
IL
Other
Enumeration date
06/14/2024
Last updated
11/13/2024
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