Terry R Roth MD PC

NPI #1265601579 in Rockford, Illinois

Provider Information

NPI Number
1265601579
Entity Type
Organization
Organization Name
Terry R Roth MD PC
Primary Specialty
Clinic/Center
Enumeration Date
Feb 21, 2008
Last Updated
Jun 25, 2015

Practice Location

Address
4920 E STATE ST
ZIP Code
61108-2272
Phone
(815) 226-1906

Authorized Official

Name
TERRY R ROTH, MD
Title
OWNER
Phone
(815) 226-1906

Specialties & Taxonomy Codes

Specialty
Clinic/Center

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