Healthcare Provider Details

I. General information

NPI: 1669063368
Provider Name (Legal Business Name): MENDING ROOTS NATUROPATHY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 BROAD ST STE 1
MILFORD CT
06460-3269
US

IV. Provider business mailing address

243 BROAD ST STE 1
MILFORD CT
06460-3269
US

V. Phone/Fax

Practice location:
  • Phone: 203-442-6297
  • Fax: 833-520-5011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE WOOMER
Title or Position: OWNER
Credential: ND, L.AC
Phone: 203-442-6297