| Doctor Name: | MR. JACK PAUL RODRIGUEZ |
| NPI Number: | 1205196532 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICENSED MASSAGE THE |
| License Number: | |
| Business Practice Address: | 3045 Jacks Run Road Chiropractic Offices-consales Health Center White Oak, PA - 15131 |
| Business Phone Number: | 4126789123 |
| Business Fax Number: | 4126789127 |
| Mailing Address: | 3787 Kelly Hollow Road, MONONGAHELA |
| State: | PA |
| Postal Code: | 150634522 |
| Phone Number: | 7242584966 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2012 |
| NPI Last Update Date: | 05/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |