DYNAMIC ROOTS WELLNESS NPI 1942789052

NPI Information

NPI: 1942789052
Provider Name: DYNAMIC ROOTS WELLNESS
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 27D2142712

Address:
605 S 1ST ST
HAMILTON, MT
ZIP 59840
Phone: (406) 360-2101
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DYNAMIC ROOTS WELLNESS is a health service clinic center in Hamilton, MT. DYNAMIC ROOTS WELLNESS NPI is 1942789052. The provider is registered as an organization entity type.

The provider's business location address is:

605 S 1ST ST
HAMILTON, MT
ZIP 59840-812
Phone: (406) 360-2101
Fax: (406) 363-7092

The provider's authorized official is Angela Rea Haugo .
The authorized official title is Physician and has the following contact phone number (406) 360-2101.

The CLIA number assigned to this NPI record is 27D2142712 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2018 and was last updated on 8/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	12829	MONTANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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