MEDICARE: DR. ELIZABETH E ROTH DC

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	2253	CO

General Provider Information

NPI Number	:	1881653970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH E ROTH DC

Provider Business Mailing Address
First Line	:	17627 TYCOON AVE
Second Line	:
City	:	MORRISON
State	:	CO
Zip	:	80465
Country	:	US
Telephone Number	:	303-697-3888
Fax Number	:	303-697-3889

Provider Business Practice Location Address
First Line	:	17627 TYCOON AVE
Second Line	:
City	:	MORRISON
State	:	CO
Zip	:	80465
Country	:	US
Telephone Number	:	303-697-3888
Fax Number	:	303-697-3889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	01/09/2008

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Directions to “ DR. ELIZABETH E ROTH DC” Practice Location

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