MEDICARE: TAPROOT REVIVAL, 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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1982571105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAPROOT REVIVAL, LLC

Provider Business Mailing Address
First Line	:	1404 NW ITHACA AVE
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-2114
Country	:	US
Telephone Number	:	319-929-6414
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 NW HILL ST
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-2922
Country	:	US
Telephone Number	:	319-929-6414
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSIE NEUZIL
Credential	:	LMT
Telephone Number	:	319-929-6414

Provider Enumeration Date	:	10/22/2025
Last Update Date	:	10/22/2025

Similar Medicare Providers

1922600188 — LAURA SHURDEN LMT
Practice Location Address:

707 NW HILL ST
BEND, OR
97703-2922

Practice Phone: 970-250-9255
Practice Fax:

1144813619 — BLISS OUT WELLNESS LLC
Practice Location Address:

707 NW HILL ST
BEND, OR
97703-2922

Practice Phone: 512-850-9178
Practice Fax:

1770395428 — MRS. DAISHA MARIE PETERS
Practice Location Address:

719 NW HILL ST
BEND, OR
97703-2922

Practice Phone: 541-420-3454
Practice Fax:

1114931847 — MS. WINIFRED RENE KING MD
Practice Location Address:

14637 PEBBLE BEND DR
HOUSTON, TX
77068-2922

Practice Phone: 936-224-7990
Practice Fax: 936-224-3154

1780699652 — POSITIVE HEALTH MANAGEMENT, INC.
Practice Location Address:

14637 PEBBLE BEND DR
HOUSTON, TX
77068-2922

Practice Phone: 832-484-8400
Practice Fax: 832-484-1675

1316084437 — AZURE KARLI ND
Practice Location Address:

715 NW HILL ST
BEND, OR
97701-2922

Practice Phone: 541-389-9750
Practice Fax: 541-389-2250

Directions to “TAPROOT REVIVAL, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.