Individual
MRS. SANDRA ELAINE ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6194 E MAIN ST, MONTEREY, IN 46960-9297
(574) 542-2552
(574) 542-2996
Mailing address
701 N MONTICELLO ST, WINAMAC, IN 46996-1138
(574) 946-4315
(574) 542-2996
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
7100817A
IN
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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