TERRY R ROTH MD PC

ROCKFORD, IL
NPI1265601579
Entity TypeOrganization
Authorized ContactTERRY R ROTH
Owner
815-226-1906
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
Enumeration Date2008-02-21
Last Update Date2015-06-25
Business Address
TERRY R ROTH MD PC
4920 E STATE ST
ROCKFORD, IL 61108-2272
Phone number: 815-226-1906
Mailing Address
TERRY R ROTH MD PC
4920 E STATE ST
ROCKFORD, IL 61108-2272
Phone number: 815-226-1906