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General NPI Number Information
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NPI Number | 1427939776
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Entity Type | Individual
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Provider Name | DORINE KAY ROTH PT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 11111 S 84TH ST RM 6222
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City | PAPILLION
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State | NE
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Zip | 68046-4122
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Country | US
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Telephone | 402-537-3498
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 LOCKWOOD PL
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-7772
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Country | US
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Telephone | 402-690-5881
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 840
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License Number State | NE
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