Individual
DISHA ANITA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5400 LAUREL LAKE DR, WACO, TX 76710-2835
(254) 772-4644
Mailing address
825 PEEVEY LN, ROBINSON, TX 76706-7140
(254) 733-6973
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2068813
TX
Other
Enumeration date
12/19/2016
Last updated
12/19/2016
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