Individual
ANDREA LYNN ROTH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1001 E 17TH ST, INDIANA UNIVERSITY ATHLETICS, BLOOMINGTON, IN 47408-1590
(812) 855-4500
(812) 855-1810
Mailing address
1001 E 17TH ST, INDIANA UNIVERSITY ATHLETICS, BLOOMINGTON, IN 47408-1590
(812) 855-4500
(812) 855-1810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/07/2005
Last updated
07/08/2007
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