Individual
SARAH E ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3305 N BALLARD RD STE C, APPLETON, WI 54911-9001
(920) 735-9234
Mailing address
135 WILLIS CT, NORTH FOND DU LAC, WI 54937-1054
(920) 926-1086
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10
WI
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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