Healthcare Provider Details

I. General information

NPI: 1679415541
Provider Name (Legal Business Name): EVEXIA METABOLIC HEALTH AND LONGEVITY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 METRO BLVD STE B
EDINA MN
55439-2128
US

IV. Provider business mailing address

7200 METRO BLVD STE B
EDINA MN
55439-2128
US

V. Phone/Fax

Practice location:
  • Phone: 952-486-3869
  • Fax:
Mailing address:
  • Phone: 952-486-3869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID RAY ROETMAN
Title or Position: OWNER, PROVIDER
Credential: D.C. M.SC.
Phone: 952-486-3869