Individual
ADAM ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CO
Contact information
Practice address
4109 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6894
(260) 432-8886
(260) 432-1137
Mailing address
408 E WASHINGTON ST, BUTLER, IN 46721-1179
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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