Root Function Wellness Pllc

LBN: Root Function Wellness Pllc
Root Function Wellness Pllc is an health care organization with primary practice located at 2320 9Th Ave Se , Watertown SD 57201-7112. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Root Function Wellness Pllc can be contacted via phone (605) 753-0920, or through Wagoner, Amy via phone (605) 880-0679.

Contact Information

Primary practice address
2320 9Th Ave Se Watertown SD 57201-7112
Phone: (605) 753-0920
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wagoner, Amy Doctor of Medicine (MD)
Phone: (605) 880-0679

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1437629128
LBN Legal business name Root Function Wellness Pllc
DBA Doing business as
Authorized official Wagoner, Amy Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 26th, 2018
Last updated Nov 26th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437629128 NPPES
South Dakota MEDICAID 1376554568

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