Individual
LISA ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3529 RIVERS EDGE DR, PERRYSBURG, OH 43551-1672
(419) 874-2428
Mailing address
7500 BERRIDGE RD, WHITEHOUSE, OH 43571-9336
(419) 944-6566
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003994
OH
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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