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Individual
MARC ROTH
Active
Individual
MARC ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20969
MD
2251P0200X
Pediatric Physical Therapist
20969
MD
Other
Enumeration date
02/27/2012
Last updated
03/01/2012
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