Individual
TRAVIS L ROETHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 STATE AVE, FARIBAULT, MN 55021-6319
(507) 333-3300
Mailing address
924 1ST ST NE, FARIBAULT, MN 55021-5441
(507) 333-3300
(507) 333-3214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9141
MN
Other
Enumeration date
01/03/2006
Last updated
10/26/2020
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