Individual
MARISA PILAR RODDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
4197
NM
2251X0800X
Orthopedic Physical Therapist
4197
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10171568
—
NM
01
—
326556
FACILITY MEDICARE
NM
Enumeration date
09/17/2012
Last updated
03/06/2017
Update your record
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