Terry Roth Md Pc

NPI 1265601579 - Clinic/Center - 261Q00000X

NPI Details
NPI 1265601579
Enumeration Date 02/21/2008
Last Updated 06/25/2015
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name TERRY R TERRY
Position OWNER
Phone (815) 226-1906
Fax (815) 226-8474
Practice Location
4920 E STATE ST
ROCKFORD IL, 61108-2272, US
Phone (815) 226-1906
Fax (815) 226-8474
Business Location
4920 E STATE ST
ROCKFORD IL, 61108-2272, US
Phone (815) 226-1906
Fax (815) 226-8474
Toxanomy
Taxonomy Code 261Q00000X
License State
License Number
Remove 1265601579 NPI Number
 

According to our database, Terry Roth Md Pc NPI is 1265601579, taxonomy code is 261Q00000X Terry Roth Md Pc physically located at 4920 E State St, Rockford IL, 61108-2272. NPI Number 1033115704 has the healthcare provider type.

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1265601579 NPI number is provided on an as is basis without warranty of any kind. 1265601579 is maintained by the National Plan & Provider Enumeration System. The contents of Terry Roth Md Pc are for informational purposes only.