Individual
BRANDILYN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAE, AT
Contact information
Practice address
60 COTTERREW DR, APT 104, BLACKLICK, OH 43004-9585
(216) 470-2172
Mailing address
60 COTTERREW DR, APT 104, BLACKLICK, OH 43004-9585
(216) 470-2172
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003047
OH
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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