Individual
AMY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
540 S. MAIN ST, MT. ANGEL, OR 97362-0000
(503) 845-6841
(503) 845-9229
Mailing address
540 S. MAIN ST, MT. ANGEL, OR 97362-0000
(503) 845-6841
(503) 845-9229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
296670
OR
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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