Individual ProviderAmber RothPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address112 Independence Way Ste 170, Clyde, OH 43410-9811(567) 855-2807(419) 609-1112PECOS EnrollmentBased on the most recent information from CMS, provider Amber Roth does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1780112003Provider TypeIndividualFull NameRoth, AmberCredentialPTGenderFemaleSole ProprietorNoEnumeration Date5/31/2017Last Updated9/10/2019Contact InformationPractice LocationPractice Address112 Independence Way Ste 170, Clyde, OH 43410-9811Phone(567) 855-2807Fax(567) 855-2808Mailing LocationMailing AddressPO Box 378, Sandusky, OH 44871-0378Phone(419) 609-1112Fax(419) 502-3537Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT016905Ohio