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1679609630
CAROLYN ROTH
BLOOMINGTON, IL
NPI
1679609630
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209000155)
Enumeration Date
2007-02-26
Last Update Date
2009-11-20
Business Address
-- CAROLYN ROTH N.P.
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704-2101
Phone number: 309-664-3038
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Mailing Address
-- CAROLYN ROTH N.P.
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704-2101
Phone number: 309-664-3000
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