Individual
ROBERT C ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., M.S., ACSM-CPT
Contact information
Practice address
380 HICKORY ST NW, ALBANY, OR 97321-1726
(541) 812-3302
Mailing address
401 S 15TH ST, PHILOMATH, OR 97370-9205
(503) 680-3549
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1043016
OR
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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