Individual
MARY C. ROTH
Active
Individual
MARY C. ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7074
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102255329
OWCP
—
Enumeration date
08/11/2006
Last updated
02/24/2023
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