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Individual

MRS. ANGELA MARIE ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2448 S 102ND ST, SUITE 340, MILWAUKEE, WI 53227-2466
(414) 329-2500
Mailing address
408 N SWIFT ST, GLENBEULAH, WI 53023-1149

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2531-26
WI

Other

Enumeration date
12/29/2011
Last updated
12/29/2011
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