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General NPI Number Information
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NPI Number | 1114800240
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Entity Type | Organization
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Legal Business Name | REROOT MASSAGE THERAPY AND ENERGY WORK, LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 24 W OREGON AVE
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City | CRESWELL
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State | OR
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Zip | 97426-9259
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Country | US
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Telephone | 541-357-8333
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Fax | 541-895-3359
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Provider Business Mailing Address
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Address Line | 527 PEBBLE BEACH DR
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City | CRESWELL
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State | OR
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Zip | 97426-9882
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Country | US
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Telephone | 916-835-2232
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER, LMT
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Name | MS. ROOPKIRAN KAUR
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Credential | LMT, RD
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Telephone | 541-357-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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