| NPI | 1548800915 |
|---|---|
| Doing Business As | REVIVING ROOTS THERAPY & WELLNESS |
| Entity Type | Organization |
| Authorized Contact | MARLEE DORSEY President 612-445-7781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-09-24 |