Provider Demographics
NPI:1437930401
Name:ROOT WELLNESS LLC
Entity Type:Organization
Organization Name:ROOT WELLNESS LLC
Other - Org Name:ROOT WELLNESS PHYSIOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-917-8567
Mailing Address - Street 1:3795 POUDRE DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4863
Mailing Address - Country:US
Mailing Address - Phone:303-917-8567
Mailing Address - Fax:
Practice Address - Street 1:3795 POUDRE DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4863
Practice Address - Country:US
Practice Address - Phone:303-917-8567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty