Individual
FERNANDO RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
875 7TH ST, SPRINGFIELD, OR 97477-4064
(541) 744-4810
Mailing address
875 7TH ST, SPRINGFIELD, OR 97477-4064
(541) 744-4810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1006180
OR
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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