Basic Information
| Provider Information | |||||||||
| NPI: | 1881170025 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUES | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1563 W 25TH AVE | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974051816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415150079 | ||||||||
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| Practice Location | |||||||||
| Address1: | 425 ALEXANDER LOOP | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974016524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413456199 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2018 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.