Grass Roots Health Foods
NPI #1679843700 in Eagle River, Wisconsin
Provider Information
- NPI Number
- 1679843700
- Entity Type
- Organization
- Organization Name
- Grass Roots Health Foods
- Primary Specialty
- Medical Foods Supplier
- Enumeration Date
- Jan 5, 2012
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 3440 STATE HIGHWAY 70 E
- City
- Eagle River
- State
- Wisconsin
- ZIP Code
- 54521-9491
- Phone
- (715) 479-6299
Authorized Official
- Name
- MR. DAVID G. KOLLER
- Title
- OWNER
- Phone
- (715) 479-6299
Specialties & Taxonomy Codes
| Specialty |
|---|
| Medical Foods Supplier |
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