Individual
MR. GREGORY ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
255 PARK AVE, SUITE 400, WORCESTER, MA 01609-1953
(978) 697-4684
(978) 779-6167
Mailing address
255 PARK AVE, SUITE 400, WORCESTER, MA 01609-1953
(978) 697-4684
(978) 779-6167
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9641
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4551239
CIGNA
MA
01
—
AA22686
HPHC
MA
01
—
Y61326
BCBS
MA
01
—
Y68133
BCBS
MA
Enumeration date
05/01/2008
Last updated
05/13/2008
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