| NPI | 1235440553 |
|---|---|
| Former Name | BROOKE M ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11523-24) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 927-39) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2014-11-15 |