Provider Demographics
NPI:1427488386
Name:RODRIGUEZ VARGAS, LUCIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:RODRIGUEZ VARGAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PHYSICIANS WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-8134
Mailing Address - Country:US
Mailing Address - Phone:615-466-5200
Mailing Address - Fax:615-466-5206
Practice Address - Street 1:101 PHYSICIANS WAY STE 115
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-8134
Practice Address - Country:US
Practice Address - Phone:615-466-5200
Practice Address - Fax:615-466-5206
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28546225100000X
AK2674225100000X
CA292717225100000X
TN10210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist