Provider Demographics
NPI:1437329323
Name:RODRIGUEZ, MEILANI T (PT)
Entity Type:Individual
Prefix:
First Name:MEILANI
Middle Name:T
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W MARTINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3194
Mailing Address - Country:US
Mailing Address - Phone:706-364-5533
Mailing Address - Fax:706-860-8765
Practice Address - Street 1:211 BOBBY JONES EXPY
Practice Address - Street 2:STE C
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5250
Practice Address - Country:US
Practice Address - Phone:706-364-5533
Practice Address - Fax:706-860-8765
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT002362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist