Healthcare Provider Details

I. General information

NPI: 1154237766
Provider Name (Legal Business Name): ROOTCAUSE MASSAGE & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6095 MARSHALEE DR STE 110
ELKRIDGE MD
21075-6082
US

IV. Provider business mailing address

9160 EMERSONS REACH
COLUMBIA MD
21045-4067
US

V. Phone/Fax

Practice location:
  • Phone: 443-945-9622
  • Fax:
Mailing address:
  • Phone: 443-945-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. VICTORIA CLUTTS
Title or Position: OWNER & OPERATOR
Credential: LMT
Phone: 602-999-7884