Individual
MRS. TRACY A ROETTIGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
338 MAIN ST, KEENE, NH 03431
(603) 357-4090
Mailing address
338 MAIN ST, KEENE, NH 03431
(603) 357-4090
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0777
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020382284
CIGNA
NH
01
—
09Y008549NH01
ANTHEM
NH
01
—
150461
HEALTHSOURCE
NH
05
—
30353754
—
NH
01
—
NH0777
EYEMED
NH
Enumeration date
02/06/2006
Last updated
01/09/2016
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