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General NPI Number Information
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NPI Number | 1699643023
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Entity Type | Organization
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Legal Business Name | ROOTS WELLNESS
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 2420 ASSEMBLY DR
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City | MCKINNEY
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State | TX
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Zip | 75072-8822
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Country | US
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Telephone | 972-754-2186
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Fax |
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Provider Business Mailing Address
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Address Line | 2420 ASSEMBLY DR
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City | MCKINNEY
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State | TX
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Zip | 75072-8822
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Country | US
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Telephone | 972-754-2186
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN MILLER
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Credential | PT
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Telephone | 469-431-0195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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