| Organization Name: | ROTH FAMILY MEDICINE,LTD. |
| NPI Number: | 1083895460 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTA ROTH (PRESIDENT) |
| Mailing Address: | 3094 W Market St Suite 136 Fairlawn |
| State: | OH US |
| Postal Code: | 443333626 |
| Phone Number: | 3308640902 |
| Fax Number: | |
| NPI Enumeration Date: | 11/14/2007 |
| NPI Last Update Date: | 11/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 35-06-6638R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |