Individual
KYLE ROTERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11148 PLUM DR, T-1791, URBANDALE, IA 50322-6328
(515) 270-6884
Mailing address
11148 PLUM DR, T-1791, URBANDALE, IA 50322-6328
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21001
IA
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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