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General NPI Number Information
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NPI Number | 1174851026
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Entity Type | Organization
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Legal Business Name | RANDALL L. ROTH, D.C.-P.C.
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Dates
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Enumeration Date | 12/03/2009
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 804 HIGDON FERRY RD
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6129
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Country | US
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Telephone | 501-881-4407
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Fax | 501-881-4407
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Provider Business Mailing Address
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Address Line | 804 HIGDON FERRY RD
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6129
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Country | US
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Telephone | 214-532-5565
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Fax | 501-881-4407
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. RANDALL L ROTH
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Credential | D.C.
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Telephone | 214-532-5565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1219
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License Number State | AR
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