Individual
BRIANNE MARIE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
147 REINHARDT COLLEGE PKWY, SUITE 9, CANTON, GA 30114-5641
(770) 345-3057
(770) 345-3154
Mailing address
147 REINHARDT COLLEGE PKWY, SUITE 9, CANTON, GA 30114-5641
(770) 345-3057
(770) 345-3154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009817
GA
225100000X
Physical Therapist
PT020058
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801841374
GROUP NPI
GA
Enumeration date
07/21/2009
Last updated
11/19/2009
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