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1164400057
TRAVIS L ROETHLER
FARIBAULT, MN
NPI
1164400057
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 9141)
Enumeration Date
2006-01-03
Last Update Date
2020-10-26
Business Address
TRAVIS L ROETHLER PA-C
300 STATE AVE
FARIBAULT, MN 55021-6319
Phone number: 507-333-3300
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Mailing Address
TRAVIS L ROETHLER PA-C
924 1ST ST NE
FARIBAULT, MN 55021-5441
Phone number: 507-333-3300
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