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Individual

MR. WILLIAM J ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
300 N MAIN ST, SALEM, SD 57058
(605) 425-2827
(605) 425-2052
Mailing address
PO BOX 316, SALEM, SD 57058-0316
(605) 425-2827
(605) 425-2052

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4018
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8502580
SD
Enumeration date
12/16/2005
Last updated
07/08/2007
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