Individual
LAURIE ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 VAN TASSEL DR, WAYNESVILLE, NC 28786-6177
(704) 408-1442
Mailing address
55 VAN TASSEL DR, WAYNESVILLE, NC 28786-6177
(704) 408-1442
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3076
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085JP
BLUE CROSS BLUE SHEILD
NC
01
—
561971088
CNC
NC
01
—
62871
ACN
NC
05
—
89085JP
—
NC
Enumeration date
07/17/2006
Last updated
02/11/2016
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