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1285305151
TRAVIS J ROTH
FORT SMITH, AR
NPI
1285305151
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-09-21
Last Update Date
2021-09-21
Business Address
TRAVIS J ROTH QBHP
3111 S 70TH ST
FORT SMITH, AR 72903-5017
Phone number: 479-452-6650
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Mailing Address
TRAVIS J ROTH QBHP
PO BOX 11818
FORT SMITH, AR 72917-1818
Phone number: 479-452-6650
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