Individual
DR. SAMUEL J ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1550 EAST BELTLINE SE, SUITE 340, GRAND RAPIDS, MI 49506
(616) 831-2000
(616) 831-2001
Mailing address
1550 EAST BELTLINE SE, SUITE 340, GRAND RAPIDS, MI 49506
(616) 831-2000
(616) 831-2001
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301006951
MI
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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