MEDICARE: ROOTED IN WELLNESS CHIROPRACTIC 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1538970660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTED IN WELLNESS CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	20730 HAMLET AVE N
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-2812
Country	:	US
Telephone Number	:	651-248-1841
Fax Number	:

Provider Business Practice Location Address
First Line	:	20730 HAMLET AVE N
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-2812
Country	:	US
Telephone Number	:	651-248-1841
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. KELSEY MARIE LLOYD
Credential	:	DC
Telephone Number	:	651-248-1841

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	01/17/2025

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