MR. Douglas Roosevelt, ND, LMT, EMT-P

NPI #1164211991 in Bloomington, Illinois

Provider Information

NPI Number: 1164211991
Entity Type: Individual
Name: MR. Douglas Roosevelt, ND, LMT, EMT-P
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Naturopath
Credential: ND, LMT, EMT-P
Enumeration Date: May 6, 2025
Last Updated: May 6, 2025

Practice Location

Address: 301 S PROSPECT RD STE 1A
City: Bloomington
State: Illinois
ZIP Code: 61704-4909
Phone: (309) 531-4584

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Naturopath	175F00000X	Primary

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