Provider Demographics
NPI:1053884858
Name:ROOTS ACUPUNCTURE AND HEALING LLC
Entity type:Organization
Organization Name:ROOTS ACUPUNCTURE AND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:ABIGAIL HOFFMAN
Authorized Official - Last Name:MUNSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:240-360-1712
Mailing Address - Street 1:1915 16TH ST NW APT 402
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3337
Mailing Address - Country:US
Mailing Address - Phone:314-609-4143
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST NW STE 620
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6920
Practice Address - Country:US
Practice Address - Phone:240-360-1712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center