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Individual

RANDALL LYNN ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
804 HIGDON FERRY RD, HOT SPRINGS, AR 71913-6129
(501) 881-4407
(501) 881-4407
Mailing address
804 HIGDON FERRY RD, HOT SPRINGS, AR 71913-6129
(501) 881-4407
(501) 881-4407

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1219
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59741
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/19/2006
Last updated
11/11/2009
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