MEDICARE: ROTH CHIROPRACTIC

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
1	111N00000X	Chiropractor	DC007534L	PA

General Provider Information

NPI Number	:	1578739603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROTH CHIROPRACTIC

Provider Business Mailing Address
First Line	:	20 S TROOPER RD
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-3050
Country	:	US
Telephone Number	:	610-539-5000
Fax Number	:	610-539-8350

Provider Business Practice Location Address
First Line	:	20 S TROOPER RD
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-3050
Country	:	US
Telephone Number	:	610-539-5000
Fax Number	:	610-539-8350

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. BRIAN SCOTT ROTH
Credential	:	D.O.
Telephone Number	:	610-539-5000

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

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Directions to “ROTH CHIROPRACTIC ” Practice Location

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