| Kristiansson Roth Pc | |
|
4445 Hwy 40 Saturday Park 503 Saint Marys GA 31558-4099 | |
| (912) 409-9879 | |
| Not Available |
| Full Name | Kristiansson Roth Pc |
|---|---|
| Speciality | Psychologist |
| Location | 4445 Hwy 40, Saint Marys, Georgia |
| Authorized Official Name and Position | Kristiansson Roth (DOCTOR) |
| Authorized Official Contact | 9124099879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristiansson Roth Pc 4445 Hwy 40 Saturday Park 503 Saint Marys GA 31558-4099 Ph: () - | Kristiansson Roth Pc 4445 Hwy 40 Saturday Park 503 Saint Marys GA 31558-4099 Ph: (912) 409-9879 |
| NPI Number | 1649503327 |
|---|---|
| Provider Enumeration Date | 09/11/2009 |
| Last Update Date | 09/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649503327 | NPI | - | NPPES |
| 118222317B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY002706 (Georgia) | Primary |
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