Marcus Roach

NPI #1467970319 in Charleston, Illinois

Provider Information

NPI Number: 1467970319
Entity Type: Individual
Name: Marcus Roach
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Aug 30, 2017
Last Updated: Aug 30, 2017

Practice Location

Address: 912 OAKCREST DR. APT D
City: Charleston
State: Illinois
ZIP Code: 61920
Phone: (217) 208-1415

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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