Provider Demographics
NPI:1366434292
Name:ROTH AND BAUM ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ROTH AND BAUM ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CHT
Authorized Official - Phone:734-425-0690
Mailing Address - Street 1:14800 FARMINGTON RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5461
Mailing Address - Country:US
Mailing Address - Phone:734-425-0690
Mailing Address - Fax:734-425-3120
Practice Address - Street 1:14800 FARMINGTON RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5461
Practice Address - Country:US
Practice Address - Phone:734-425-0690
Practice Address - Fax:734-425-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy