Individual
CHELSEY ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15898 E DAVIS RD, OPDYKE, IL 62872-3100
(618) 310-9196
Mailing address
15898 E DAVIS RD, OPDYKE, IL 62872-3100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003438
IL
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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