George J Roth, PA-C

NPI #1073720124 in Fruitland, Idaho

Provider Information

NPI Number: 1073720124
Entity Type: Individual
Name: George J Roth, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 17, 2007
Last Updated: Sep 13, 2012

Practice Location

Address: 1210 NW 16TH ST
City: Fruitland
State: Idaho
ZIP Code: 83619-2202
Phone: (208) 452-8600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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