Individual
MARY A ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2301 SOUTH 65 HIGHWAY, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 886-3328
Mailing address
2301 SOUTH 65 HIGHWAY, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 831-3328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
149803
MO
Other
Enumeration date
08/06/2008
Last updated
04/20/2012
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