Healthcare Provider Details

I. General information

NPI: 1093628372
Provider Name (Legal Business Name): ROOT & BLOOM PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 GOODENOUGH RD
BRATTLEBORO VT
05301-8969
US

IV. Provider business mailing address

516 GOODENOUGH RD
BRATTLEBORO VT
05301-8969
US

V. Phone/Fax

Practice location:
  • Phone: 631-903-2428
  • Fax:
Mailing address:
  • Phone: 631-903-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHLEY WRASE
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 631-903-2428