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General NPI Number Information
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NPI Number | 1679415541
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Entity Type | Organization
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Legal Business Name | EVEXIA METABOLIC HEALTH AND LONGEVITY CLINIC
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 7200 METRO BLVD STE B
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City | EDINA
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State | MN
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Zip | 55439-2128
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Country | US
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Telephone | 952-486-3869
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 METRO BLVD STE B
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City | EDINA
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State | MN
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Zip | 55439-2128
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Country | US
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Telephone | 952-486-3869
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | DAVID RAY ROETMAN
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Credential | D.C. M.SC.
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Telephone | 952-486-3869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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