Individual
JOSE ANTONIO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
146 CLOVER ST, WILLIAMS BAY, WI 53191-9779
(262) 245-6400
Mailing address
1227 MADISON ST, LAKE GENEVA, WI 53147-1134
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1971-19
WI
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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