| Doctor Name: | CHRISTIAN WILLIAM ROTH |
| NPI Number: | 1497747323 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, CHT |
| License Number: | 5501000577 |
| Business Practice Address: | 301 S Lafayette St South Lyon, MI - 481781407 |
| Business Phone Number: | 2484861110 |
| Business Fax Number: | 2484863318 |
| Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
| State: | IL |
| Postal Code: | 604404909 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2005 |
| NPI Last Update Date: | 11/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251H1200X |
| License Number: | 5501000577 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Hand |
| Taxonomy Definition: | |