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1083124846
LUCAS B ROTH
PEORIA, IL
NPI
1083124846
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085006385)
Enumeration Date
2017-10-06
Last Update Date
2021-06-16
Business Address
LUCAS B ROTH PA-C
6000 N ALLEN RD
PEORIA, IL 61614-3294
Phone number: 309-691-1400
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Mailing Address
LUCAS B ROTH PA-C
6000 N ALLEN RD
PEORIA, IL 61614-3294
Phone number: 309-691-1400
Copy
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