Individual
NICOLE ROETHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., ATC
Contact information
Practice address
5236 SOCIALVILLE-FOSTER ROAD, MASON, OH 45040
(513) 347-9999
Mailing address
11655 HAWK DR, HARRISON, OH 45030-8431
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2043
OH
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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