Healthcare Provider Details

I. General information

NPI: 1487577854
Provider Name (Legal Business Name): GARY ROITHNER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 RIVER BEND DR
GRANITE FALLS NC
28630-9376
US

IV. Provider business mailing address

75 DOGWOOD CT
TAYLORSVILLE NC
28681-8658
US

V. Phone/Fax

Practice location:
  • Phone: 828-212-5121
  • Fax:
Mailing address:
  • Phone: 610-438-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2546
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: