Individual
MARY J ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
47 WIDEFIELD BLVD, COLORADO SPRINGS, CO 80911-2126
(719) 282-6100
(719) 282-6106
Mailing address
47 WIDEFIELD BLVD, COLORADO SPRINGS, CO 80911-2126
(719) 282-6100
(719) 282-6106
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/18/2013
Last updated
04/18/2013
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