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General NPI Number Information
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NPI Number | 1437705613
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Entity Type | Organization
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Legal Business Name | ROOTS OF WELLNESS, PLLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 680 E MEETING ST STE E
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City | DANDRIDGE
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State | TN
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Zip | 37725-5077
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Country | US
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Telephone | 865-973-7202
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Fax | 855-691-8540
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Provider Business Mailing Address
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Address Line | 680 E MEETING ST STE E
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City | DANDRIDGE
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State | TN
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Zip | 37725-5077
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Country | US
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Telephone | 865-973-7202
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Fax | 855-691-8540
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Authorized Official
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Title or Position | OWNER, CLINIC DIRECTOR
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Name | DR. BRUCE KRISTOPHER ROFF
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Credential | DACM, LAC, LMT
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Telephone | 865-973-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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Taxonomy #3
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number |
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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Taxonomy #5
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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Taxonomy #6
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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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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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Taxonomy #8
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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Taxonomy #9
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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Taxonomy #10
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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