Individual
CARA ROESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
11709 OLD BALLAS RD, STE 205, SAINT LOUIS, MO 63141-7029
(314) 991-0480
(314) 991-0487
Mailing address
2454 W CLAY ST, SAINT CHARLES, MO 63301-2548
(636) 916-4625
(636) 916-4628
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009032395
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12698799
CAQH ID
—
Enumeration date
03/04/2014
Last updated
02/02/2015
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