STACY ROTH

CHEYENNE, WY
NPI1356307029
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ND  1136)
Enumeration Date2006-04-21
Last Update Date2007-07-08
Business Address
-- STACY ROTH MPT
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7554
Mailing Address
-- STACY ROTH MPT
5301 POTOMAC ST
CHEYENNE, WY 82001-2220
Phone number: 307-778-7554
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