Wild Roots Ot Llc | |
1057 Old Oliver Rd Walland TN 37886-2338 | |
(865) 268-9270 | |
Not Available |
Full Name | Wild Roots Ot Llc |
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Speciality | Clinic/center |
Location | 1057 Old Oliver Rd, Walland, Tennessee |
Authorized Official Name and Position | Nicole Seravello (OWNER) |
Authorized Official Contact | 2392229911 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wild Roots Ot Llc 1057 Old Oliver Rd Walland TN 37886-2338 Ph: (239) 222-9911 | Wild Roots Ot Llc 1057 Old Oliver Rd Walland TN 37886-2338 Ph: (865) 268-9270 |
NPI Number | 1932092178 |
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Provider Enumeration Date | 05/29/2025 |
Last Update Date | 05/29/2025 |
Identifier | Type | State | Issuer |
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1932092178 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |