MEDICARE: ROOTS ACUPUNCTURE AND HEALING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1053884858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTS ACUPUNCTURE AND HEALING LLC

Provider Business Mailing Address
First Line	:	1915 16TH ST NW APT 402
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-3337
Country	:	US
Telephone Number	:	314-609-4143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 P ST NW STE 620
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-6920
Country	:	US
Telephone Number	:	240-360-1712
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RENA ABIGAIL HOFFMAN MUNSTER
Credential	:	L.AC
Telephone Number	:	240-360-1712

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	08/05/2020

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Directions to “ROOTS ACUPUNCTURE AND HEALING LLC ” Practice Location

Language	Start Address	Practice Location

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