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Individual

EMILY JEAN ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4444 CORONA DR STE 107, CORPUS CHRISTI, TX 78411-4374
(361) 400-1886
Mailing address
15410 FORTUNA BAY DR UNIT 3003, CORPUS CHRISTI, TX 78418-6385
(361) 813-5886

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
956339
TX

Other

Enumeration date
01/08/2019
Last updated
01/08/2019
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