Individual
DAVID B ROTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
121 SPRINGFIELD AVE STE 4, JOLIET, IL 60435-6545
(815) 255-3220
(630) 424-0467
Mailing address
121 SPRINGFIELD AVE STE 4, JOLIET, IL 60435-6545
(815) 582-4482
(630) 424-0467
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
213000185
IL
224L00000X
Pedorthist
212000113
IL
224P00000X
Prosthetist
Primary
211000159
IL
Other
Enumeration date
02/15/2018
Last updated
04/11/2019
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