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NPI Code Detail

MEDICARE: MR. ZACHARY JAMES ROTH D.C.

MEDICARE: MR. ZACHARY JAMES ROTH D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorF1-0011115DE

General Provider Information

NPI Number : 1003259722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ZACHARY JAMES ROTH D.C.
Provider Business Mailing Address
First Line : PO BOX 7165
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-0165
Country : US
Telephone Number : 302-722-5415
Fax Number : 302-351-4160
Provider Business Practice Location Address
First Line : 101 GARDEN OF EDEN RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-1511
Country : US
Telephone Number : 302-722-5415
Fax Number : 302-351-4160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2013
Last Update Date : 05/05/2026

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