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Organization
ROOT & BRANCH LLC
Active
Organization
ROOT & BRANCH LLC
Active
Other names
Root & Branch Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN POLM DOM (CEO)
(813) 460-5222
Entity
Organization
Contact information
Practice address
3602 MADACA LN, TAMPA, FL 33618
(813) 992-5421
Mailing address
12651 N DALE MABRY HWY UNIT 270657, TAMPA, FL 33688-9028
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP3903
FL
Other
Enumeration date
03/14/2018
Last updated
07/22/2018
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