Individual
MR. CLAY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4080 W BROADWAY AVE STE 200, ROBBINSDALE, MN 55422-5606
(763) 398-8888
Mailing address
592 LINCOLN AVE APT 1, SAINT PAUL, MN 55102-3197
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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