Individual
GLENN P ROTHHAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3900 SUNFOREST CT, STE 119, TOLEDO, OH 43623-4440
(419) 472-3791
(419) 472-6219
Mailing address
3900 SUNFOREST CT, STE 119, TOLEDO, OH 43623-4440
(419) 472-3791
(419) 472-6219
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34-00-4787-R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0329424
—
OH
Enumeration date
06/27/2005
Last updated
01/31/2019
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