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Organization
BLUE RIDGE INTEGRATIVE WELLNESS LLC
Active
Organization
BLUE RIDGE INTEGRATIVE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ROGERS OWNER (OWNER)
(941) 391-7261
Entity
Organization
Contact information
Practice address
512 DRYDEN LOOP, DRYDEN, VA 24243
(941) 391-7261
Mailing address
512 DRYDEN LOOP, DRYDEN, VA 24243-8366
(252) 452-6075
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
251E00000X
Home Health Agency
—
NULL
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
Other
Enumeration date
09/19/2025
Last updated
09/18/2026
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