Organization
RACC MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ROTH DO (OWNER)
(260) 748-3650
Entity
Organization
Contact information
Practice address
330 NORTH WABASH AVE, STE 410, MARION, IN 46952-2677
(260) 748-3650
(260) 748-3651
Mailing address
PO BOX 670, HUNTERTOWN, IN 46748-0670
(260) 748-3650
(260) 748-3651
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300038645
—
IN
Enumeration date
12/09/2021
Last updated
11/16/2022
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