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Contact Information

BRIAN W ROTH, MPT
510 N GRANDSTAFF DR
AUBURN, IN46706
 Phone: 260-927-9270
 Fax: 260-927-9272
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BRIAN W ROTH · (Male)

NPI # 1033285846
Status Active
Credentials MPT (Master of Physical Therapy)
Entity Individual
Enumeration date 11/27/2006
Last updated 04/08/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 05007103A
  • IN Medicaid 200189290A
  • IN Other 4423623 AETNA
  • IN Other 000000350992 ANTHEM BCBS
  • IN Other 35179001202 CARESOURCE
  • IN Other N299947 HARMONY
  • IN Other 1424 PHP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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