Individual
SAMANTHA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8611 W POINT DOUGLAS RD S, COTTAGE GROVE, MN 55016-4005
(651) 458-1884
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15237
MN
Other
Enumeration date
12/23/2024
Last updated
03/05/2026
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