Individual
JENNIFER K ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3605
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3605
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6447-024
WI
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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