Organization
ROOTS AND RAICES FUNCTIONAL MEDICINE INC.
Active
Other names
Roots and Raices Functional Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M NAYLOR FNP-C (PRESIDENT)
(435) 267-7668
Entity
Organization
Contact information
Practice address
1452 E RIDGELINE DR STE 5, SOUTH OGDEN, UT 84405-4949
(435) 267-7668
(385) 298-4027
Mailing address
1452 E RIDGELINE DR STE 5, OGDEN, UT 84405-4949
(435) 919-7668
(801) 689-3985
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2019
Last updated
01/02/2020
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