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Organization
RIVER VALLEY FOOT & ANKLE CLINIC
Active
Organization
RIVER VALLEY FOOT & ANKLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE ROTH DPM (PODIATRIST)
(479) 968-3338
Entity
Organization
Contact information
Practice address
703 W MAIN ST, RUSSELLVILLE, AR 72801-3616
(479) 968-3338
Mailing address
PO BOX 10424, RUSSELLVILLE, AR 72812
(479) 647-6443
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
245
AR
Other
Enumeration date
09/19/2011
Last updated
01/19/2012
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