Individual provider · NPI-1

Anita Kaye Rothert

Specialist/Technologist, Other · Southgate, MI

NPI number1376911107
StatusActive
Last updated in NPPESSep 10, 2015

Details

NPI
1376911107
Entity type
Individual (NPI-1)
Name
Mrs. Anita Kaye Rothert
Sex
Female
Sole proprietor
No
Enumeration date
Sep 10, 2015
Last updated
Sep 10, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Z00000X Specialist/Technologist, Other––Yes

Practice location

19401 Northline Rd
Southgate, MI 48195-2277

Phone 734-239-3406

Mailing address

13101 Allen Rd
Southgate, MI 48195-2216

Phone 734-239-3406

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