Healthcare Provider Details

I. General information

NPI: 1811814122
Provider Name (Legal Business Name): LOCAL ROOTS CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 CENTRAL AVE NE
EAST GRAND FORKS MN
56721-1605
US

IV. Provider business mailing address

1010 S 18TH ST
GRAND FORKS ND
58201-4255
US

V. Phone/Fax

Practice location:
  • Phone: 701-335-6373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: GRACE DRISCOLL
Title or Position: OWNER
Credential: DC
Phone: 218-791-3254