Individual
MR. GARY L ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
143 LAKEWOOD DR, KILLINGTON, VT 05751-9476
(802) 773-4943
Mailing address
143 LAKEWOOD DR, KILLINGTON, VT 05751-9476
(802) 773-4943
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
0720000081
VT
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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