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Individual

ROBERTA VOTAVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
3147 14TH ST S APT D, MOORHEAD, MN 56560-5154
(218) 512-0429

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0519
ND
225100000X
Physical Therapist
2593
MN

Other

Enumeration date
10/14/2016
Last updated
10/14/2016
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