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Individual

MR. ROBERT THOMAS ROCHE III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.T.C.

Contact information

Practice address
9520 VIKING DR, EDEN PRAIRIE, MN 55344-3825
(612) 741-5645
(952) 828-6555
Mailing address
378 BRICKYARD DR, CHASKA, MN 55318-2403
(612) 741-5645
(952) 828-6555

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1939
MN

Other

Enumeration date
07/24/2006
Last updated
07/08/2007
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