Organization
ROTH MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM TERRENCE ROTH MD (OWNER)
(509) 483-4403
Entity
Organization
Contact information
Practice address
220 E ROWAN AVE STE 200, SPOKANE, WA 99207-1203
(509) 483-4403
(509) 489-7556
Mailing address
220 E ROWAN AVE STE 200, SPOKANE, WA 99207-1203
(509) 483-4403
(509) 489-7556
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD 00035230
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111145
—
WA
Enumeration date
04/26/2011
Last updated
04/26/2011
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