Individual
LAURA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
Mailing address
7116 EASTERN AVE SE, GRAND RAPIDS, MI 49508-7435
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/19/2016
Last updated
06/19/2016
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