Adam Roth, CO
NPI #1184156093 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1184156093
- Entity Type
- Individual
- Name
- Adam Roth, CO
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Credential
- CO
- Enumeration Date
- Mar 30, 2017
- Last Updated
- Mar 30, 2017
Practice Location
- Address
- 4109 W JEFFERSON BLVD
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46804-6894
- Phone
- (260) 432-8886
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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