Organization
ROOTS OF WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE KRISTOPHER ROFF DACM, LAC, LMT (OWNER, CLINIC DIRECTOR)
(865) 973-7202
Entity
Organization
Contact information
Practice address
680 E MEETING ST STE E, DANDRIDGE, TN 37725-5077
(865) 973-7202
(855) 691-8540
Mailing address
680 E MEETING ST STE E, DANDRIDGE, TN 37725-5077
(865) 973-7202
(855) 691-8540
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
171100000X
Acupuncturist
Primary
—
—
174H00000X
Health Educator
—
—
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
225700000X
Massage Therapist
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000326
STATE OF TENNESSEE
TN
01
—
0000012878
SATE OF TENNESSEE
TN
01
—
115084
NCCAOM
—
Enumeration date
08/14/2019
Last updated
08/14/2019
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