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General NPI Number Information
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NPI Number | 1285247932
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Entity Type | Organization
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Legal Business Name | ROOT AND BRANCH LLC
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 08/24/2020
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Provider Practice Location Address
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Address Line | 965 PAYNE AVE
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City | SAINT PAUL
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State | MN
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Zip | 55130-4194
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Country | US
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Telephone | 612-458-6892
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Fax |
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Provider Business Mailing Address
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Address Line | 1034 HUMBOLDT AVE
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City | WEST ST PAUL
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State | MN
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Zip | 55118-1431
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | EMILY HONL
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Credential | MT
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Telephone | 612-636-3541
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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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