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Kelly Ann Roth, CPO
Prosthetist in Crown Point, Indiana
NPI 1790209864

Kelly Ann Roth is a Prosthetist based in Crown Point, IN. Kelly Ann Roth practices in Crown Point, IN and has the professional credentials of CPO. The NPI Number for Kelly Ann Roth is 1790209864 and holds a License No. 213000351 (Indiana).

The current practice location address for Kelly Ann Roth is 1450 E Joliet St Ste 206, Crown Point, IN and can be reached out via phone at 219-801-3937 and via fax at 219-301-8734.

Location: 1450 E Joliet St Ste 206, Crown Point, IN, 46307-4726
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790209864
Provider Name
Kelly Ann Roth
Credential
CPO
Provider Entity Type
Individual
Gender
Female
Address
1450 E Joliet St Ste 206, Crown Point, IN, 46307-4726
Phone Number
219-801-3937
Fax Number
219-301-8734
Provider Enumeration Date
08/01/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1450 E Joliet St Ste 206
City
Crown Point
State
Indiana
Zip
46307-4726
Phone Number
219-801-3937
Fax Number
219-301-8734
person
Provider Business Mailing Address Details
Address
1450 E Joliet St Ste 206
City
Crown Point
State
Indiana
Zip
46307-4726
Phone Number
219-801-3937
Fax Number
219-301-8734
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Orthotist
Speciality
-
Taxonomy
222Z00000X
License No.
211000319 (Illinois)
Definition
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Prosthetist
Speciality
-
Taxonomy
224P00000X
License No.
213000351 (Illinois)
Definition
A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
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