ROOTS AND RAICES FUNCTIONAL MEDICINE INC. NPI 1952955296

NPI Information

ROOTS AND RAICES FUNCTIONAL MEDICINE INC. is a health service clinic center in South Ogden, UT. ROOTS AND RAICES FUNCTIONAL MEDICINE INC. NPI is 1952955296. The provider is registered as an organization entity type.
The provider Other Name Is Roots And Raices Functional Medicine.

The provider's business location address is:

1452 E RIDGELINE DR STE 5
SOUTH OGDEN, UT
ZIP 84405-949
Phone: (435) 267-7668
Fax: (385) 298-4027

The provider's authorized official is Susan M Naylor .
The authorized official title is President and has the following contact phone number (435) 267-7668.

The enumeration date for this NPI number is 7/25/2019 and was last updated on 1/2/2020.

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:

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