Individual
CHRISTIAN WILLIAM ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, CHT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501000577
MI
2251H1200X
Hand Physical Therapist
5501000577
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H71069
BCBSMI
MI
05
—
4709236
—
MI
Enumeration date
08/17/2005
Last updated
11/11/2014
Update your record
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