Individual
BONNIE J ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10065 E HARVARD AVE STE 400, DENVER, CO 80231-5943
(303) 614-1500
Mailing address
902 S MCKINLEY AVE, FORT LUPTON, CO 80621-1283
(303) 717-0919
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
96793
CO
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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