Individual
HOLLY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1075 MCCOLLOCH ST, WHEELING, WV 26003-3133
(304) 551-4749
Mailing address
1075 MCCOLLOCH ST, WHEELING, WV 26003-3133
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125553494
—
WV
05
—
1356607394
—
WV
05
—
1821206228
—
WV
Enumeration date
10/21/2021
Last updated
10/21/2021
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