Individual
TARA L. ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
14365 RIVER CREST DR, ROGERS, MN 55374-8914
(612) 669-0046
(763) 428-8749
Mailing address
14365 RIVER CREST DR, ROGERS, MN 55374-8914
(612) 669-0046
(763) 428-8749
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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