Individual
DR. EARL J ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
721 CENTURY AVE, ANTIGO, WI 54409-2473
(715) 623-5300
Mailing address
721 CENTURY AVE, ANTIGO, WI 54409-2473
(715) 623-5300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3510
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350055781
RAILROAD MEDICARE
WI
05
—
38937600
—
WI
Enumeration date
12/18/2006
Last updated
08/02/2023
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