Individual
MR. GREGORY ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
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
Update your record
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